Method for producing cytotoxic T-cells

ABSTRACT

The invention relates to the method for producing antipeptide cytotoxic T lymphocytes (CTLs) by attaching a complex of a class I HLA and a peptide to antigen presenting cell(s) (APCs) present in a sample of peripheral blood lymphocytes (PBLs), optionally removing excess class I HLA/peptide complex, and incubating with proliferative cytokine. The invention further relates to a CTL obtainable by these methods and to a method of treating a subject by administering such a CTL to the subject.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation-in-part of U.S. application Ser. No. 10/116,901, filed Apr. 5, 2002, which is a continuation-in-part of U.S. application Ser. No. 09/878,158, filed Jun. 8, 2001, which is a continuation-in-part of U.S. application Ser. No. 09/724,985, filed Nov. 28, 2000, as a continuation-in-part of PCT/GB99/01764, filed Jun. 4, 1999, designating the U.S., published as WO 99/64464 and claiming priority to UK applications Serial Nos. 9812227.8, filed Jun. 5, 1998 and 9908333.9, filed Apr. 12, 1999. This application is also a continuation-in-part of U.S. application Ser. No. 09/878,158, filed Jun. 8, 2001. And, this application is also a continuation-in-part of U.S. application Ser. No. 09/724,985, filed Nov. 28, 2000.

[0002] Each of the foregoing applications and patents, each foregoing publication, and each document cited or referenced in each of the foregoing applications and patents, including during the prosecution of each of the foregoing applications and patents (“application and article cited documents”), and any manufacturer's instructions or catalogues for any products cited or mentioned in each of the foregoing applications and patents and articles and in any of the application and article cited documents, are hereby incorporated herein by reference. Furthermore, all documents cited in this text, and all documents cited or referenced in documents cited in this text, and any manufacturer's instructions or catalogues for any products cited or mentioned in this text or in any document hereby incorporated into this text, are hereby incorporated herein by reference. Documents incorporated by reference into this text or any teachings therein may be used in the practice of this invention. Documents incorporated by reference into this text are not admitted to be prior art.

BACKGROUND OF THE INVENTION

[0003] Cytotoxic T cells in the cellular immune system are responsible for recognising cells that display “foreign” markings, and triggering an immunological response against such cells. Each cytotoxic T cell expresses a number of cell surface recognition receptors, which recognition receptors all possess precise specificity for a particular “foreign” peptide sequence, which recognition receptors are adapted to bind to HLA class I molecules expressed on the surface of cells scanned by the T cell. HLA class I molecules are cell surface molecules which possess a peptide binding groove exposed on the external surface of the cell, which groove is arranged under normal circumstances to bind a peptide derived from the interior of the cell. When a recognition receptor on a cytotoxic T cell binds to an HLA class I molecule on the surface of a scanned cell, the recognition receptor is enabled to contact the peptide binding groove of the HLA class I molecule and interact with any peptide contained therein. If this peptide matches the specificity of the recognition receptor, the T cell is said to recognise the scanned cell, and may consequently trigger an immunological response against said scanned cell.

[0004] Cytotoxic T cells of various specificities within a host immune system are also able to recognise and trigger an immunological response against a cell exhibiting an HLA class I molecule which is of a different allotype from the HLA class I molecules of the host cells. An immunological response of this kind is known as an “alloreactive” response.

[0005] An immunological response against a cell usually results in the lysis of the cell and/or the local release of cytokines. It has however been observed that cytotoxic T cells do not trigger the lysis of so-called antigen presenting cells (APCs) in this way. Instead, the immunological response triggered by T cell recognition of an HLA class I molecule on the surface of an antigen presenting cell results in the direct selective proliferation of the cytotoxic T cell. The host immune system consequently becomes immurised against any cells exhibiting the foreign peptide recognised by the surface recognition receptors on this T cell.

[0006] It is recognised that the effector mechanisms of the cellular immune system could be a powerful tool in the prevention and treatment of many illnesses, including malignant processes and infectious and auto-immune diseases, including cancer. A small number of the HLA class I molecules on a tumour cell surface may be found to bind peptides which are selectively expressed or over-expressed in tumour cells and are capable of being recognised by cytotoxic T cells in the immune system. Such peptides may furthermore be tumour specific, being found only infrequently, or not at all, on the HLA class I molecules of non-tumour cells. An example of one such tumour specific peptide is the HMW-MAA antigen found on melanoma cells. However, the number of HLA molecules presenting such peptides is generally too small to stimulate an effective immunological response against the tumour cell. Moreover, such peptides are rarely, if ever, presented by HLA class I molecules on the surface of APCs.

[0007] Attempts to enhance the response of the cellular immune system to tumour cells have hitherto focused on increasing tumour cell immunogenicity. In particular, various efforts have been made to produce high-level expression of immunogenic HLA class I molecules on the surface of tumour cells, through the techniques of gene therapy. The delivery of cDNA encoding an HLA class I gene containing an immunogenic peptide in the leader sequence of the HLA molecule has been described in Kang (Cancer Res. 57, 1997, 202-205). Meanwhile, Stopeck (J Clinical Oncolosv 15, 1997, 341-349) describes the transfection of allogeneic HLA class I in patients with melanoma. This work has demonstrated some response in clinical trials, but has also highlighted the difficulties involved in targeting tumour cells at multiple sites in vivo through the techniques of gene therapy.

[0008] Existing technology for production of alloreactive peptide specific cytotoxic T lymphocytes (CTLs) requires mixing donor cells with, initially, RMA cells (mouse cancer line), CIR or T2 cells (human tumour cell), and then Drosophila cells. This is both complicated and of low efficacy. These methods are also very ‘dirty’ which in this context means that they use cancer cells. It is undesirable to use cancer cells in the production of CTLs for administration to a subject.

[0009] Existing methods for producing CTLs in vitro are very labour intensive and expensive, involving culture of at least three different cell lines and complicated procedures of contacting the CTLs with each of these as part of the method(s). It is an advantageous feature of the present invention that CTL production is simplified and is also cheaper and/or easier and/or faster than existing techniques.

[0010] Subjects can be known to tolerate their own tumours rather than mounting an immunological response to them. This is because the tumour can appear as ‘own’ or ‘self’ to the immune system. Other people's immune systems (i.e. alloreactive) can fight better. However, the drawback with this approach is that a dual response can be produced in that the ordinary tissues of the recipient can be attacked too. This is the so-called graft versus host disease. The actual host can be attacked, which is problematic. One of the advantages of the present invention is the alleviation of this problem with existing methods by provision of better CTLs, which react with the target peptide in the appropriate context, such as when complexed with HLA-A2.

[0011] A number of approaches to the generation of anti-tumour CTLs, including use of dendritic cells, DNA vaccines and peptide administration are in clinical development, aiming to expand autologous tumour reactive CTLs. However producing autologous CTLs against certain targets is difficult or impossible due to immunological tolerance, and existing attempts at producing alloreactive CTLs have serious drawbacks as explained above (Sadovnikova 1998, Stauss 1999, Dutoit 2002).

[0012] Furthermore, some. target peptides apparently cannot be targeted by autologous means. Melan-A is an example of a peptide that can be targeted by autologous methods, but many others such as WT1 cannot be targeted by such methods. The present invention advantageously permits the targeting of a far wider range of peptides than conventional autologous methods.

[0013] Other techniques for production of CTLs have been described, such as production using T2 cells. T2 cells are a genetically altered human cell line, which is deficient in the genes encoding the transporter associated with antigen processing (TAP). This cell line therefore fails to properly load HLA-A2 Class I molecules with endogenous peptides. Therefore, exogenously added peptides can be made to bind a proportion of the HLA-A2 molecules on the surface of T2 cells. These techniques for producing CTLs rely on the culture of T2 cells, followed by peptide loading, cleaning of the cells and using them as a stimulatory cell to try to stimulate CTLs, for example from PBMC samples. Even when this labour intensive method appears to work, the stimulatory cells have to be constantly prepared and replaced at regular intervals in a rolling maintenance program. The present invention advantageously avoids the use of such T2 cells and also greatly simplifies the procedure. Furthermore, use of T2 cells is limited to HLA-A2, whereas the methods of the present invention are also applicable to other HLA types.

[0014] The existing technologies employed to produce alloreactive CTLs are relatively inefficient and the choice of target HLA class I is restricted by the limited allotypes of the commonly used antigen presenting cells, which are themselves genetically altered artificial cell lines.

[0015] It is desirable to separate out the beneficial effects of alloreactive transplants ‘graft versus leukaemia (tumour) effect’ from the unwanted ‘graft versus host disease’. Thus, the present invention relates to a method for the production of alloreactive peptide specific CTLs.

[0016] The production of alloreactive CTLs is advantageous over autologous CTLs because a subject may be tolerant to the autologous HLA peptide combination whilst tolerance in the alloreactive setting is much less likely. Thus the present invention relates to production of CTLs against a given HLA /peptide complex from a foreign donor (alloreactive) rather than autologous.

[0017] Without being bound by theory, it may be that some HLA types can produce better reactivity against certain other HLA types. For example, making an anti-HLA-A2 response may be easier for an HLA1 background but more difficult for an HLA4 background. The methods of the present invention may be advantageously applied to the study of this phenomenon.

OBJECTS AND SUMMARY OF THE INVENTION

[0018] It will be appreciated that the invention relates to the production of alloreactive anti-peptide CTLs. Preferably the peptide is a tumour peptide or other antigenic peptide associated with a disorder such as cancer. The peptide may be a modified peptide such as a glycopeptide.

[0019] In this aspect, the invention relates to the treatment of a sample of CTLs in such a way as to promote the selection and expansion of CTLs having the desired reactivity. In this manner, alloreactive anti-peptide CTLs are advantageously produced.

[0020] In another aspect, the invention provides a method for producing antipeptide CTLs. comprising; providing a sample of peripheral blood lymphocytes (PBLs), attaching a complex of a class I HLA and a peptide to antigen presenting cell(s) (APCs) present in said PBLs, optionally removing excess class I HLA/peptide complex, and incubating with proliferative cytokine.

[0021] In a further aspect, the invention provides a method as described above wherein the APC is a B-cell.

[0022] The invention also provides a method as described above wherein the complex is attached to the APC by attachment means comprising a molecule capable of selective binding to a B cell.

[0023] In still another aspect, the invention provides a method as described above wherein the attachment means comprises sfvSA to CD20 or CD19.

[0024] The invention additionally provides a method as described above wherein said sample of PBLs is a sample of a class I HLA negative PBLs.

[0025] In another aspect, the invention provides a method as described above wherein the class I HLA is HLA-A2.

[0026] In a further aspect, the invention provides a method as described above wherein the peptide is a tumour peptide.

[0027] In an additional aspect, the invention provides a method as described above wherein the tumour peptide is selected from the group consisting of Melan-A, WT1 and a telomerase.

[0028] The invention also provides a method as described above wherein the proliferative cytokine is a combination of IL-7 and IL-2.

[0029] In another aspect, the invention provides a method as described above wherein the incubation is about 7 days. In another aspect, the invention provides a method as described above wherein the incubation step is repeated for a further 7 days.

[0030] In another aspect, the invention provides a CTL obtainable or obtained by the methods described above, and a method of treating a subject comprising. administering a CTL as described above to said subject.

[0031] In a preferred aspect, the production of alloreactive anti-tumour CTLs is accomplished in vitro. In a further preferred aspect, the present invention relates to a method for treating a subject comprising administering to said subject a sample of alloreactive CTLs according to the present invention.

[0032] Other technology for production of alloreactive peptide specific CTLs requires mixing donor PBLs with, initially, RMA cells (mouse cancer line), CIR cells (human tumour cell), and then Drosophila cells. This is both complicated and of low efficacy. These methods are also very ‘dirty’ which in this context means they use cancer cells. It is clearly undesirable to use cancer cells in the production of CTLs for administration to a subject. Thus, it is an advantage of the present invention that the use of cancer cells in the production of CTLs is avoided. In a preferred aspect of the invention, only PBLs and recombinant peptides/proteins are employed in said methods.

[0033] The term “comprising” in this disclosure can mean “including” or can have the meaning commonly given to the term “comprising” in U.S. Patent Law.

[0034] Other aspects of the invention are described in or are obvious from (and within the ambit of the invention) the following disclosure.

BRIEF DESCRIPTION OF DRAWINGS

[0035] Reference is made to the following accompanying figures, incorporated herein by reference:

[0036]FIG. 1 shows a diagram showing the method/idea for delivering HLA molecules to the surface of tumour cells.

[0037]FIG. 2 shows a FACs analysis of HLA-A2 −ve Mel 2 melanoma cells treated with biotin-conjugated monoclonal antibody 225.28s, avidin, biotin-conjugated HLA-A2/gag complexes, anti-HLA-A2 monoclonal antibody BB7.2 and phycoerythrin-conjugated rabbit anti-mouse antibody.

[0038]FIG. 3 shows the results of a T cell cytotoxicity chromiun release assay with Mel I cells treated with the delivery system of biotin-conjugated monoclonal antibody 225.28s, avidin, and biotin-conjugated HLA-A2/gag complexes. These cells were incubated with HLA-A2/gag specific cytotoxic T cells with effector/target ratios of 0:1-20:1 for 20 hours.

[0039]FIG. 4 shows a diagram showing the method/idea for delivering HLA class I/peptide complexes to antigen presenting cells.

[0040]FIG. 5 shows the results of an ELISA assay, described in Example 2 below, for demonstrating the stability of various MHC class I/peptide complexes at 37° C. The results shown are the mean of assays performed on each sample in triplicate.

[0041]FIG. 6 shows a FACS analysis of HLA-class 1 deficient Daudi cells targeted with HLA-A2 via biotinylated anti-CD20 mAb. Trace 1 (lefthand trace) corresponds to native untargeted Daudi cells. Trace 2 (righthand trace) corresponds to Daudi cells targeted with mAb/avidin/HLA-A2/gag/FITC anti-MHC class I. Mean fluorescence trace 1=0.31, mean fluorescence trace 2=24.3 (arbitrary fluorescence units).

[0042]FIG. 7 shows the results of a four hour chromium release assay, described in Example 2 below, in which HLA class I-deficient Daudi cells targeted with various components of the HLA-A2/gag delivery system were incubated with HLA-A2/gag specific cytotoxic T cell clones. A comparison was made with native and peptide-pulsed 221.A2 cells (HLA-A2+ve).

[0043]FIG. 8 shows the results of a four hour chromium release assay, described in Example 2 below, in which HLA-A2/gag targeted Daudi cells were incubated with HLA-A2/gag-specific and HLA-A2/Melan A-specific cytotoxic T cell clones.

[0044]FIG. 9 shows the results of a twenty hour chromium release assay, described in Example 2 below, in which HLA-A2+ve SK29.Mel cells were incubated with HLA-A2/gag specific cytotoxic T cell clones.

[0045]FIG. 10 shows 5 graphs. In more detail, FIG. 10 shows a FACs analysis of the time course of binding of HLA-A2/M1 peptide complexes to HLA class I−ve cells (Daudi) via an antibody bridge, detected with an FITC conjugated anti-MHC monoclonal antibody (W6/32) (This antibody (Ancell Ltd.) recognises HLA class I that is conformationally correct.)

[0046]FIG. 11 shows a bar chart, four scatterplots, a further barchart, four further scatterplots, and six further scatterplots. In more detail, FIG. 11 illustrates the result of a Tetramer FACs analysis of the cells cultured from peripheral blood cells incubated with or without the anti-CD20 B9E9-streptavidin fusion protein and HLA-A2/M1 peptide complex. The cells are dual stained with a FITC conjugated monoclonal antibody to CD8 and a PE conjugated HLA-A2 tetramer with specificity for HLA-A2/MI. FIG. 11 further shows the results of Tetramer FACs analysis of the cells cultured from PBLs incubated with either the anti-CD20 B9E9-streptavidin fusion protein alone (sample C) or the anti-CD20 B9E9streptavidin-fusion protein plus either the HLA-A2/MI peptide complex (sample F) or the HLA-A2/BMLF1 peptide complex (sample I). Cells from these samples were then dual stained with a FITC conjugated monoclonal antibody to CD8 and a PE conjugated HLA-A2 tetramer with specificity for HLA-A2/MI or HLA-A2/BMLF1 as indicated.

[0047]FIG. 12 shows schematic representation of the two-step targeting system delivering HLA-class I peptide complexes to the surface of B cells. Step 1 is the delivery of the antiCD20 B9E9 sfvScSA fusion protein. Step 2 the delivery of recombinant biotinylated HLA class I peptide. These steps are followed by the selective proliferation of peptide specific CTLs.

[0048]FIG. 13 shows time course analysis of HLA-A2/M1 complexes immobilized on the surface of HLA-class 1 −ve Daudi cells via B9E9 sfvScSA. Complexes are detected via the binding of W6/32 which binds conformationally correct HLA-class I. Daudi cells targeted with B9E9 sfvScSA alone are shown in grey, in black are Daudi cells targeted with B9E9 sfvScSA and HLA-A2/M1.

[0049]FIG. 14 shows sequential flow cytometry analysis of expression of CD80 and CD86 on CD 19+ve B cells within the PBMC population. The unstimulated controls are shown on the narrow trace, the experimental results from PBMCs targted with the B9E9 sfvScSA are shown in bold.

[0050]FIG. 15 shows FACs and Cr release assay results from PBMCs stimulated with targeted HLA-A2/M1 complexes. Tetramer results demonstrate staining with anti-CD8 and HLA-A2/M1 tetramer. The Cr release assay demonstrates activity against Daudi cells bearing HLA-A2/M1 complexes. Stimulation protocols: 1/PBMCs alone, 2/PBMCs+B9E9 sfvScSA, 3/PBMCs+free HLA-A2/BMLF1, 4/PBMCs+B9E9 sfvScSA+HLA-A2/BMLF1.

[0051]FIG. 16 shows FACs and Cr release assay results from PBMCs stimulated with either A) B9E9 sfvScSA alone or B) B9E9 sfvScSA and targeted HLA-A2/BMLF1 complexes. Tetramer staining results are shown for both HLA-A2/M1 and HLA-A2/BMLF1. The Cr release assay demonstrates PBMC at E:T 10:1 against native/M1/BMLF1 peptide pulsed CIR-A2 target cells.

[0052]FIG. 17 shows FACs and Cr release assay results from PBMCs stimulated twice with either 1) targeted HLA-A2/M1 complexes or 2) targeted HLA-A2/Melan A complexes. Tetramer results are a/unstimulated, b/targeted once and c/targeted twice. The Cr release assay with twice targeted PBMCs shows the activity against native and peptide pulsed CIR-A2 cells at E:T 20:1.

[0053]FIG. 18 shows six plots (donor MG HLA-A2 negative) of CTLs which are specific for HLA-A2/M1 (flu) and HLA-A2 Melan-A (melanoma) as measured after 0, 1 or 2 rounds of stimulation.

[0054]FIG. 19 shows six plots (three HLA-A2/M1 and three HLA-A2/Melan-A) after 0, 1 and 2 rounds of stimulation (see example 7).

[0055]FIG. 20 shows a schematic representation of the two step targeting system delivering HLA-A2/peptide complexes to the surface of B cells from HLA-A2 −ve donors. The presence of the immobilised complexes on the B cells leads to expansion of alloreactive CTL populations.

[0056]FIG. 21 shows four plots (0, 1, 2 and 3) demonstrating the increasing population of CTLs through cycles of stimulation from 0.12% at 0 cycles to 17.3% after 3 cycles, demonstrated by Tetramer staining with HLA-A2/MelanA tetramer.

[0057]FIG. 22 shows four plots (Melan-A, M1, Telo and E7) demonstrating the specificity of CTLs for the target HLA-A2/peptide complex.

[0058]FIG. 23 shows Donor MG Tetramer analysis of PBMCs demonstrating the increasing numbers of tetramer positive cells with repeated cycles of stimulation with targeted HLA-A2/Melan-A (23 a) or HLA-A2/M1 (23 b).

[0059]FIG. 24 shows Donor PS Tetramer analysis of CTLs produced with targeted HLA-A2/Melan-A and HLA-A2/WT1 complexes. Staining of both PBMC groups with a panel of 5 HLA-A2 tetramers demonstrates significant staining only with the appropriate tetramer.

[0060]FIG. 25 shows Donor BQ Tetramer analysis of CTLs produced with targeted HLA-A2/Melan-A and HLA-A2/WT1 complexes. Staining of the HLA-A2/Melan-A PBMCs with the panel of 5 HLA-A2 tetramers demonstrates significant staining only with the appropriate tetramer. Staining of the HLA-A2/WT1 PBMCs demonstrate similar levels of staining with all 5 tetramers.

[0061]FIG. 26 shows donor PS 4 hr Chromiuim (Cr) release assays using PBMCs targeted with 4 cycles of HLA-A2/Melan-A (26 a) or 4 cycles of HLA-A2/WT1 (26 b) tested against native and peptide pulsed T2 cells. Both groups of PBMCs show significant peptide specificity towards the immunising peptide complex.

[0062]FIG. 27 shows donor BQ 4 hour Cr release assays using PBMCs targeted with 4 cycles of HLA-A2/Melan-A (27 a) or 4 cycles of HLA-A2/WT1 (27 b) tested against native and peptide pulsed T2 cells. The cells from the HLA-A2/Melan-A PBMCs show a small degree of peptide specificity, while the HLA-A2/WT1 PBMCs show no significant lysis of any of the T2 cells.

DETAILED DESCRIPTION

[0063] The present invention sets out to provide improved means for producing or enhancing an immunological response against a target cell, and to provide an improved method for treating or preventing cancer and other malignant, infectious or auto-immune diseases, conditions or symptoms.

[0064] Accordingly, in one aspect of the present invention there is provided a method for producing antipeptide CTLs comprising providing a sample of PBLs, attaching a complex of a class I HLA and a peptide to APCs present in said PBLs, optionally removing excess class I HLA/peptide complex, and incubating with proliferative cytokine.

[0065] In another aspect of the present invention there is provided a method of treating a subject comprising administering a CTL obtainable or obtained by providing a sample of PBLs, attaching a complex of a class I HLA and a peptide to APCs present in said PBLs, optionally removing excess class I HLA/peptide complex, and incubating with proliferative cytokine.

[0066] HLA/Peptide Complex

[0067] The HLA class I molecule or fragment thereof may bind a peptide, which peptide is arranged to be presented for T cell recognition by said HLA class I molecule or fragment thereof. Said peptide may be attached to the HLA class molecule or fragment thereof in accordance with the method described in Garboczi (PNAS 89, 1992, 3429-3433).

[0068] The attaching means preferably comprises a linking polypeptide with high specific affinity for a target cell specific molecule on the surface of the target cell. By “target cell specific molecule” herein is meant any molecule that is characteristically expressed or overexpressed on the surface of the target cell. By way of example, in cancer cells said “target cell specific molecule” could include any of the following tumour associated antigens:carcinoembryonic antigen, placental alkaline phosphatase, polymorphic epithelial mucin, human chorionic gonadotrophin, CD20, prostate specific antigen, ca-125, HMW-MAA and others.

[0069] Conveniently, the linking polypeptide will comprise an antibody, preferably a monoclonal antibody, raised against said target cell specific molecule (Riethmuller and Johnson, Curr. Opin. Immunol. 4, 1992, 647-655). Suitable antibodies for this purpose include C46, 85A12, H17E2, HMFGI, W14, 1F5, 225.28s (Buraggi 1985 Cancer Res. 45. 3378-3387), and others. Deposits of the immortalised hybrids producing these antibodies have been made at the American Type Culture Collection, Rockville Md., U.S.A. Further examples of antibodies are described in Maloney et al (Blood 84, 1994, 2457-2466), Riethmuiler et al (Lancet 343, 1994, 1177-1183) and Hird et al (Br. J. Cancer 68, 1993, 403-406).

[0070] Said linking polypeptide may comprise an antibody raised against a target cell specific molecule and a coupling system for coupling said antibody to said HLA class I molecule or fragment thereof. The coupling system may comprise a two- or three-step chain of well-characterised paired small molecules, joined to the antibody and the HLA class I molecule so as to form a stable bridge between the two. Examples of paired small molecules which might be used in this connection include (but are not limited to) biotin and avidin/streptavidin (Moro, 1997 Cancer Res. 57, 1922-1928; Altman et al, Science 274, 1996, 9496), and calmodulin and calmodulin binding peptides (Neri, 1996, J. Invest. Dermatol. 107, 164-170). Alternatively, said linking polypeptide may comprise an antibody-raised against a target cell specific molecule, which. antibody is adapted to be attached directly to said HLA class I molecule or fragment thereof.

[0071] In a further possible embodiment of the invention, said complex may comprise a recombinant protein, which recombinant protein includes a moiety comprising said HLA class I molecule or fragment thereof, and a moiety comprising said attaching means.

[0072] The HLA class I molecule or fragment thereof may be purified from plasma or platelets or made recombinantly. The HLA class I molecule or fragment thereof may further be arranged to bind and present for T cell recognition a defined peptide of choice, such as a viral, bacterial, parasitic, or tumour-specific peptide. Attachment of the HLA class I molecule or fragment thereof to the target cell may be achieved by introducing said HLA class I molecule or fragment thereof and said attaching means to the vicinity of the target cell. The target cell may be a culture cell in vitro, but will advantageously be in the body of a patient. Preferably, the target cell will be arranged to be contacted by a cytotoxic T cell, which cytotoxic T cell is adapted to recognise said HLA class I molecule or fragment thereof either as being of a mismatched allotype or as binding a foreign peptide, and which cytotoxic T cell is capable of triggering an immunological response against said target cell.

[0073] The HLA/peptide complex for use in production of alloreactive CTLs may be any HLA/peptide complex that is of immunological interest. In a preferred embodiment, the HLA used in the complex is the same HLA for which the PBLs (i.e. the CTLs) are negative. Preferably, the HLA is a class I HLA. Preferably the class I HLA comprises one or more of HLA-A1, HLA-A2, HLA-A3 or HLA-B7. In a preferred embodiment, the HLA is HLA-A2. Thus, in a highly preferred embodiment, the CTLs are HLA-A2 negative and the HLA in the complex is HLA-A2. Specific examples of HLA/peptide complexes include, but are not limited to, HLA class I/telomerase (pan tumor), HLA-A2/melan A (melanoma), HLA-A2WT1 (leukaemia), or any other peptides of interest. Further examples of peptides of interest are given in Tables 1-7. TABLE 1 Class I HLA-restricted cancer/testis antigens. All these antigens were found to be expressed by normal spermatocytes and/or spermatogonia of testis. Occasionally MAGE-3, MAGE-4 and the GAGE genes were found to be expressed also in placenta. The NY-ESO-1 antigen was found to be expressed in normal ovary cells. HLA Gene allele Peptide epitope Author Tissue distribution among tumorsa MAGE-A1 A1 EADPTGHSY Traversari et al., 1992 Melanoma, breast carcinoma, SCLC - MAGE-A1 A3 SLFRAVITK Chaux et al., 1999a sarcoma, NSCLC - thyroid medullary MAGE-A1 A24 NYKHCFPEI Fujie et al., 1999 carcinoma - colon carcinoma - MAGE-A1 A28 EVYDGREHSA Chaux et al., 1999a laryngeal tumors MAGE-A1, -A2- B37 REPVTKAEML Tanzarella et al., 1999 Melanoma, colon and breast carcinomas, A3, -A6 SCLC - sarcoma, NSCLC - thyroid medullary carcinoma, H/N tumors, bronchial SCC - laryngeal tumors - leukemias MAGE-A1 B53 DPARYEFLW Chaux et al., 1999a Melanoma, breast carcinoma, SCLC - MAGE-A1 Cw2 SAFPTTINF Chaux et al., 1999a sarcoma, colon carcinoma, NSCLC - MAGE-A1 Cw3 SAYGEPRKL Chaux et al., 1999a thyroid medullary carcinoma MAGE-A1 Cw16 SAYGEPRKL van der Bruggen et al., 1994b MAGE-A2 A2 KMVELVHFL Visseren et al., 1997 Melanoma, colon and breast carcinomaa, MAGE-A2 A2 YLQLVFGIEV Visseren et al., 1997 SCLC - sarcoma, NSCLC - thyroid medullary MAGE-A2 A24 EYLQLVFGI Tahara et al., 1999 Carcinoma - laryngeal tumors - leukemias MAGE-A3 A1 EVDPIGHLY Gaugler et al., 1994 Melanoma, colon and breast carcinomas - MAGE-A3 A2 FLWGPRALV van der Bruggen et al., 1994a H/N tumors - bronchial SCC, thyroid MAGE-A3 A24 TFPDLESEF Oiso et al., 1999 medullary and bladder carcinoma, MAGE-A3 A24 IMPKAGLLI Tanaka et al., 1997 sarcomas, SCLC, NSCLC - leukemias MAGE-A3 B44 MEVDPIGHLY Herman et al., 1996 MAGE-A3 B52 WQYFFPVIF Fleischhauer et al., 1996 Russo et al. 2000 MAGE-A4 A2 GVYDGREHTV Duffour et al., 1999 Melanoma, NSCLC, sarcomas, esophageal, colon and breast carcinomas MAGE-A6 A34 MVKISGGPR Zorn and Hercend, 1999b Melanoma, NSCLC, colon carcinoma, leukemias MAGE-A10 A2 GLYDGMEHL Huang et al., 1999 Not defined MAGE-A12 Cw7 VRIGHLYIL Panelli et al., 2000, Melanoma, myeloma, brain tumors, Heidecker et al., 2000 sarcoma, leukemias, SCLC, NSCLC, H/N tumors, bladder, lung, esophageal, breast, prostate and colorectal carcinoma BAGE Cw16 AARAVFLAL Boël et al., 1995 Melanoma, bladder and mammary carcinomas, H/N SCC, NSCLC, sarcoma DAM-6, -10 A2 FLWGPRAYA Fleischhauer et al., 1998 Melanoma, skin tumors, mammary and ovarian carcinomas - lung carcinoma - seminomas GAGE-1, -2, -8 Cw6 YRPRPRRY Van den Eynde et al., 1995 Melanoma, sarcoma, NSCLC, SCLC, De Backer et al. 1999 mesothelioma, sarcoma, seminoma, leukemias, lymphomas, H/N tumors, bladder, esophageal, mammary, colon, prostate carcinomas GAGE-3, -4, -5,- A29 YYWPRPRRY De Backer et al. 1999 Melanomas, H/N tumors, leukemias, 6, -7B esophageal, lung and bladder carcinomas NA88-A B13 MTQGQHFLQKV Moreau-Aubry et al., 2000 Melanoma NY-ESO-1 A2 SLLMWITQCFL Jäger et al., 1998 Melanoma, sarcoma, B-lymphomas, NY-ESO-1a A2 SLLMWITQC Jäger et al., 1998 hepatoma, H/N tumors, bladder, lung, (CAG-3) A2 QLSLLMWIT Jäger et al., 1998 prostate, ovarian, thyroid and breast A31 ASGPGGGAPR Wang et al., 1998b carcinoma

[0074] TABLE 2 Class I HLA-restricted melanocyte differentiation antigens. These antigens can only be expressed in normal and neoplastic cells of the same lineage (namley melanocytes, skin, retina, peripheral ganglia) or in normal cells of the prostate gland. HLA Peptide Gene allele epitope Authors MART-1/ A2 AAGIGILTV Coulie et al. 1994 Melan-A^(a) Kawakami et al., 1994a A2 EAAGIGILTV Schneider et al., 1998 A2 ILTVILGVL Castelli et al., 1995 B45 AEEAAGIGIL Schneider et al., 1998 B45 AEEAAGIGILT Schneider et al., 1998 MC1R A2 TILLGIFFL Salazar-Onfray et al., 1997 A2 FLALIICNA Salazar-Onfray et al., 1997 Gp100 A2 KTWGQYWQV Bakker et al., 1995 A2 AMLGTHTMEV Tsai et al., 1997 A2 MLGTHTMEV Tsai et al., 1997 A2 SLADTNSLAV Tsai et al., 1997 A2 ITDQVPFSV Kawakami et al., 1995 A2 LLDGTATLRL Kawakami et al, 1994b A2 YLEPGPVTA Cox et al., 1994 A2 VLYRYGSFSV Kawakami et al., 1995 A2 RLMKQDFSV Kawakami et al., 1998 A2 RLPRIFCSC Kawakami et al., 1998 A3 LIYRRRLMK Kawakami et al., 1998 A3 ALNFPGSQK Kawashima et al., 1998 A3 SLIYRRRLMK Kawashima et al, 1998 A3 ALLAVGATK Skipper et al., 1996 A24 VYFFLPDHL Robbins et al., 1997 Cw8 SNDGPTLI Castelli et al., 1999 PSA A1 VSHSFPHPLY Corman et al., 1998 A2 FLTPKKLQCV Correale et al., 1997 A2 VISNDVCAQV Correale et al., 1997 PSM A1 HSTNGVTRIY Corman et al., 1998 Tyrosinase A1 KCDICTDEY Kittlesen et al., 1998 A1 SSDYVIPIGTY Kawakami et al., 1998 A2 YMDGTMSQV Wölfel et al., 1994 A2 MLLAVLYCL Wölfel et al., 1994 A24 AFLPWHRLF Kang et al., 1995 B44 SEIWRDIDF Brichard et al., 1996 TRP-1 A31 MSLQRQFLR Wang et al., 1996b (or gp75) TRP-2 A2 SVYDFFVWL Parkhurst et al., 1998 A2 TLDSQVMSL Noppen et al., 2000 A31 LLGPGRPYR Wang et al., 1996a A33 LLGPGRPYR Wang et al, 1998a Cw8 ANDPIFVVL Castelli et al., 1999

[0075] TABLE 3 Class I HLA-restricted widely expressed antigens. HLA Peptide Tissue distribution Gene allele epitope Tumors Normal tissues Reference ART-4 A24 AFLRHAAL SCC, SCLC, H/N tumors, Testis, placenta, fetal liver Kawano et al, 2000 DYPSLSATDI leukemia, lung, esophageal, gastric, cervical, endometrial, ovarian and breast carcinomas CAMEL A2 MLMAQEALAFL Melanoma Testis, placenta, heart, skeletal Aarnoudse et al., 1999 muscle, pancreas CEA A2 YLSGANLNL Melanoma Testis, placenta, heart, skeletal Tsang et al., 1995 (CAP-1)^(a) muscle, pancreas CEA A3 HLFGYSWYK Colon, rectum, pancreas, gastric, Gastrointestinal embryonic tissue Kawashima et al., 1999 breast and lung carcinomas Cyp-B A24 KFHRVIKDF Lung adenocarcinoma, T cell Ubiquitously expressed in normal Gomi et al., 1999 DFMIQGGDF leukemia, lymphosarcoma - tissues. bladder, ovarian, uterine and esophageal SCC HER2/neu A2 KIFGSLAFL Melanoma - ovarian and breast Epithelial cells Fisk et al., 1995 carcinomas HER2/neu A2 IISAVVGIL Melanoma, ovarian, pancreatic^(b) Epithelial cells Peoples et al, 1995 and breast carcinomas HER2/neu A2 RLLQETELV Melanoma, ovarian, gastric, Epithelial cells Kono et al., 1998 pancreatic and breast carcinomas HER2/neu A2 VVLGVVFGI Melanoma, ovarian, gastric, Epithelial cells Rongcun et al., 1999 ILHNGAYSL pancreatic and breast carcinomas YMIMVKCWMI HER2/neu A3 VLRENTSPK Melanoma, ovarian, gastric, Epithelial cells Kawashima et al., 1999 pancreatic and breast carcinomas hTERT^(c) A2 ILAKFLHWL Lung and ovarian carcinomas - Hematopoietic stem cells and Vonderheide et al., 1999 multiple myeloma, melanoma, progenitors; germinal center cells; sarcoma, acute leukemias, non- basal keratinocytes; gonadal cells; Hodgkin's lymphomas certain proliferating epithelial cells hTRT^(c) A2 ILAKFLHWL Lung, prostate and ovarian Circulating B cells; germinal Minev et al., 2000 RLVDDFLLV carcinomas, multiple myeloma, center B cells; thymocytes; melanoma, sarcoma, acute CD34+ progenitor hematopoietic leukemias, non-Hodgkin's cells lymphomas iCE B7 SPRWWPTCL RCC Kidney, colon, small intestine, Ronsin et al., 1999 liver, heart, pituitary gland, adrenal gland, prostate, stomach MUC1 A11 STAPPAHGV Breast and ovarian carcinomas, None^(d) Domenech et al. 1995 multiple myeloma, B-cell lymphoma MUC1 A2 STAPPVHNV Breast and ovarian carcinoma, None^(d) Brossart et al., 1999 multiple myeloma, B-cell lymphoma MUC2 A2 LLNQLQVNL Ovary, pancreas and breast Colon, small intestine, bronchus, Böhm et al., 1998 MLWGWREHV mucinous tumors, colon cervix and gall bladder carcinoma of non-mucinous type PRAME A24 LYVDSLFFL Melanoma, H/N and lung SCC, Testis, endometrium, ovary, Ikeda et al., 1997 NSCLC, RCC, adenocarcinoma, adrenals, kidney, brain, skin sarcoma, leukemias P15 A24 AYGLDFYIL Melanoma Testis, spleen, thymus, liver, Robbins et al., 1995 kidney, adrenal tissue, lung tissue, retinal tissue RU1 B51 VPYGSFKHV Melanoma, renal and bladder Testis, kidney, heart, skin, brain, Morel et al, 2000 carcinomas ovary, liver, lung, lymphocytes, thymus, fibroblasts RU2 B7 LPRWPPPQL Melanoma, sarcomas, leukemia - Testis, kidney, liver, urinary Van den Eynde et al. 1999 brain, esophageal and H/N bladder tumors - renal, colon, thyroid, mammary, bladder, prostatic and lung carcinomas SART-1 A24 EYRGFTQDF Esophageal, H/N and lung SCC - Testis, fetal liver Kikuchi et al, 1999 adenocarcinoma, uterine cancer SART-1 A*2601 KGSGKMKTE Esophageal, H/N and lung SCC, Testis, fetal liver Shichijo et al., 1998 adenocarcinoma, uterine cancer SART-3 A24 VYDYNCHVDL H/N, esophageal and lung SCC, Lymphoid cells, fibroblasts, Yang et al., 1999 AYIDFEMKI adenocarcinoma, leukemia, testis, fetal liver melanoma WT1 A2 RMFPNAPYL Gastric, colon, lung, breast, Kidney, ovary, testis, spleen Oka et al., 2000 ovary, uterine, thyroid and hepatocellular carcinomas - leukemia (including AML, ALL and CML)

[0076] TABLE 4 Class I HLA-restricted tumor specific antigens, including both unique (CDK-4, MUM-1, MUM-2, β-catenin, HLA-A2-R170I, ELF2m, myosin-m, caspase-8, KIAA0205, HSP70-2m) and shared (CAMEL, TRP-2/INT2, GnT-V, G 250) antigens. HLA Tissue distribution Gene allele Peptide epitope Tumors Normal tissues Reference AFP A2 GVALQTMKQ Hepatocellular carcinoma Fetal liver Butterfield et al, 1999 β-catenin/m A24 SYLDSGIHF Melanoma None Robbins et al. 1996 Caspase-8/m B35 FPSDSWCYF H/N tumors None Mandruzzato et al., 1997 CDK-4/m A2 ACDPHSGHFV Melanoma None Wölfel et al., 1995 ELF2M A68 ETVSEQSNV Lung SCC None Hogan et al., 1998 GnT-V A2 VLPDVFIRC(V)^(a) Melanoma, brain tumors, sarcoma Breast and brain (low expression) Guilloux et al., 1996 G250 A2 HLSTAFARV RCC, colon, ovarian and cervical None Vissers et al., 1999 carcinomas HA-A*0201- A2 CVEWLRIYLEN RCC None Brandle et al., 1996 R170I GK HSP70-2M A2 SLFEGIDIY RCC, melanoma, neuroblastoma None Gaudin et al., 1999 HST-2 A31 YSWMDISCWI Gastric signet cell carcinoma None Suzuki et al., 1999 KIAA0205 B44*03 AEPINIQTV Bladder cancer None Gueguen et al., 1998 MUM-1 B44 EEKLIVVLF Melanoma None Coulie et al., 1995 MUM-2 B44 SELFRSGLDY Melanoma None Chiari et al., 1999 MUM-2 Cw6 FRSGLDSYV Melanoma None Chiari et al., 1999 MUM-3 A28 EAFIQPITR Melanoma None Baurain et al., 2000 Myosin/m A3 KINKNPKYK Melanoma None Zom and Hercend, 1999a RAGE B7 SPSSNRIRNT Melanoma, sarcomas, Retina only Gaugler et al., 1996 mesotheliomas, H/N tumors, bladder, renal, colon and mammary carcinomas SART-2 A24 DYSARWNEI H/N and lung SCC, lung None Nakao et al., 2000 AYDFLYNYL adenocarcinoma, RCC, melanoma, SYTRLFLIL brain tumors, esophageal and uterine cancers TRP-2/INT2 A68 EVISCKLIKR Melanoma None Lupetti et al., 1998 TRP-2/INT2 A68 EVISCKLIKR Melanoma None Lupetti et al., 1998 707-AP A2 RVAALARDA Melanoma None^(b) Morioka et al., 1995

[0077] TABLE 5 Class II HLA-restricted antigens. Tissue expression Gene HLA- allele Peptide epitope Tumors Normal tissues Reference Epitopes from normal protein antigens Annexin II DRB*0401 DVPKWISIMTERSVPH Melanoma Not done Li et al., 1998 Gp100 DRB1*0401 WNRQLYPEWTEAQRLD Melanoma Melanocytes Li et al., 1998 MAGE-1, -2, -3, -6 DRB*1301, LLKYRAREPVTKAE Melanoma, lung and Testis, placenta Chaux et al.; 1999a DRB*1302 breast carcinomas, H/N SCC MAGE-3 DR*1101 TSYVKVLHHMVKISG Melanoma, lung and Testis, placenta Manici et al., 1999 breast carcinomas, H/N SCC MAGE-3 DRB*1301, AELVHFLLLKYRAR Melanoma, lung and Testis, placenta Chaux et al., 1999b DRB*1302 breast carcinomas, H/N SCC MART-1/Melan-A DRB1*0401 RNGYRALMDKSLHVGTQCALTRR Melanoma Melanocytes Zarour et al., 2000 MUC1 DR3 PGSTAPPAHGVT Breast and ovarian None^(a) Hiltbold et al., 1998 cancers, multiple myeloma, B-cell lymphoma NY-ESO-1 DRB4*0101 VLLKEFTVSG Melanoma, B- Testis Zeng et al., 2000 lymphoma, hepatoma^(b), sarcoma, H/N tumors, - bladder, lung, prostate, ovarian, thyroid and breast carcinomas NY-ESO-1 DRB4*0101- PLPVPGVLLKEFTVSGNI B-lymphoma, Testis Jäger et al. 2000 0103 VLLKEFTVSGNILTIRLT melanoma, sarcoma, AADHRQLQLSISSCLQQL H/N tumors, hepatoma - bladder, lung, prostate, ovarian, thyroid and breast carcinomas PSA DR4 ILLGRMSLFMPEDTG Prostate carcinoma Prostate gland Corman et al., 1998 SLFHPEDTGQVFQ QVFQVSHSFPHPLYD NDLMLLRLSEPAELT KKLQCVQLHVISM GVLQGITSMGSEPCA Tyrosinase DRB1*0401 QNILLSNAPLGPQFP Melanoma Melanocytes Topalian et al., 1994 DYSYLQDSDPDSFQD Topalian et al., 1996 SYLQDSDPDSFQD Tyrosinase DRB1*1501 RHRPLQEVYPEANAPIGHNRE Melanoma Melanocytes Kobayashi et al., 1998a Tyrosinase DRB1*0405 EIWRDIDFAHE Melanoma Melanocytes Kobayashi et al, 1998b Epitopes from mutated protein antigens HPV-E7 DR*0401, LFMDTLSFVCPLC Cervical carcinoma None Höhn et al., 1999 DR*0407 LFMDSLNFVCPWC CDC27/m DRB1*0401 FSWAMDLDPKGA Melanoma None Wang et al., 1999a TPI/m DRB1*0101 GELIGILNAAKVPAD Melanoma None Pieper et al., 1999

[0078] TABLE 6 Epitopes derived from fusion proteins (fusion proteins are never found in normal tissues). Tissue HLA distribution Gene allele Peptide epitope among tumors Reference HLA class I restricted epitopes bcr-abl^(a) A2 FMVELVEGA CML Buzyn et al., 1997 KLSEQESLL MLTNSCVKL bcr-abl p210(b3a2) A2 SSKALQRPV CML Yotnda et al., 1998a bcr-abl (b3a2) A3 ATGFKQSSK CML Greco et al., 1996 KQSSKALQR bcr-abl p210 (b3a2) A3, A11 HSATGFKQSSK CML Bocchia et al., 1996 bcr-abl p210(b3a2) A3 KQSSKALQR CML Norbury et al., 2000 bcr-abl p210(b3a2) B8 GFKQSSKAL CML Norbury et al., 2000 ETV6/AML A2 RIAECILGM ALL Yotnda et al., 1998b HLA class II restricted epitopes bcr-abl p190 (e1a2) DRB1*1501 EGAFHGDAEALQRPVAS ALL Tanaka et al., 2000 bcr-abl p210 (b2a2) DRB5*0101 IPLTINKEEALQRPVAS CML ten Bosch et al., 1999 bcr-abl p210 (b3a2) DRB1*0401 ATGFKQSSKALQRPVAS CML ten Bosch et al., 1996 bcr-abl p210 (b3a2) DRB1*1501 ATGFKQSSKALQRPVAS CML ten Bosch et al., 1995 bcr-abl (b3a2) DRB1*0901 ATGFKQSSKALQRPVAS CML Yasukawa et al., 1998 bcr-abl (b3a2) DRB1*1101 LIVVIVHSATGFKQSSKALQRPVA CML Pawelec et al., 1996 bcr-abl (b3a2) DR11 IVHSATGFKQSSKALQRPVASDFEP CML Bocchia et al., 1996 Dek-cain DRB4*0103 TMKQICKKEIRRLHQY AML Ohminami et al., 1999 LDLR/FUT DRB1*0101 GGAPPVTWRRAPAPG Melanoma Wang et al., 1999b WRRAPAPGAKAMAPG Pml/RARα DR11 NSNHVASGAGEAAIETQSSSSEEIV APL Gambacorti-Passerini et al., 1993 p190 minor bcr-abl (e1a2) DRB1*1501 EGAFHGDAEALQRPVAS AML Tanaka et al., 2000 TEL/AML1 DP5, DP17 IGRIAECILGMNPSR AML Yun et al., 1999

[0079] TABLE 7 Frequency of epitopes recognized by a given HLA allele, No. of Antigen epitopes HLA-A HLA-B HLA-C MAGE-1, -2, -3, -4, 24 13 (54%) 7 (29%) 4 (17%) -6, -10, -12 GAGE-1, -2, -3, -4, 8  5 (62.5%) 0 3 (37.5%) -5, -6, -7B, -8 MART-1 6  4 (67%) 2 (33%) 0 Gp100 12 11 (92%) 0 1 (8%) Tyrosinase 6  5 (83%) 1 (17%) 0

[0080] Attachment

[0081] In this embodiment of the invention, the attachment means is capable of selectively binding to an APC, and to the HLA/peptide complex. Preferably the APC is a B cell. Preferably the complex is attached to the APC by attachment means comprising a molecule capable of selective binding to a B cell. Preferably the attachment means comprises sfvSA to CD20 or CD19. Preferably the attachment means comprises sfvSA to CD20, such as the B9E9 moiety.

[0082] Target Cells

[0083] In one embodiment of the present invention the target cell is of a type which may be lysed as a result of an immunological response thereagainst. Advantageously, the target cell is a tumour cell or any diseased or foreign cell the presence of which is undesired in a patient, such as a cancer cell, leukaemia cell, a cell infected with the HIV virus or with any other microbe or virus, a cell responsible for detrimental activity in auto-immune disease, and so on. In order to accelerate the triggering of an immunological response against said target cell in a patient, said HLA class I molecule or fragment thereof will preferably be capable of producing a powerful immune response from the cellular immune system of the patient. Accordingly, said HLA class I molecule or fragment thereof may bind a viral or microbial peptide, preferably a viral or microbial peptide to which the patient is likely to have had previous exposure. In particular, said HLA class I molecule or fragment thereof may bind an influenza virus peptide, a measles virus peptide, an Epstein-Barr virus peptide, in particular an Epstein-Barr. virus peptide comprising the RAKFFQLL epitope of the lytic protein BZLFI, a Cytomegalovirus peptide, or a tetanus toxoid peptide. Alternatively, said HLA class I molecule or fragment thereof may bind any peptide which already has a strong cytotoxic T cell response or which is capable of inducing a powerful immune response. The allotype of said HLA class I molecule or fragment thereof may additionally be different from the allotype of the HLA class I molecules of the patient, so that an alloreactive response may additionally be triggered against said target cell.

[0084] In another embodiment of the invention the target cell is an antigen presenting cell (APC). Recognition by a cytotoxic T cell of an HLA class I molecule or fragment thereof attached to said APC may result in direct and selective proliferation of the cytotoxic T cell. Accordingly, said HLA class I molecule or fragment thereof will advantageously be adapted to present for T cell recognition a tumour specific peptide as defined above, or a viral peptide, or a bacterial peptide, or a parasitic peptide, or any peptide which is exclusively or characteristically presented by HLA class I molecules on the surface of diseased, malignant or foreign cells the presence of which is undesirable in a patient. Peptides linked to malignant conditions have been characterised (Brossart, 1998 Cancer Res. 58. 732-736 and Lucas, 1998 Cancer Res. 58, 743752), as have peptides of parasitic origin (Khusmith, 1991 Science 252, 715718). The attachment of an HLA class I molecule or fragment thereof to an APC, in accordance with the present invention, may be used for in vivo immunisation against cells presenting a given peptide, or ex vivo production of cytotoxic T cells of a particular specificity.

[0085] Where the target cell is a tumour cell or microbially infected cell, the pharmaceutical composition of the present invention may be used for the treatment of a tumour or microbial disease respectively, and there is provided a method of treating a tumour or microbial disease in a patient, comprising the step of administering to a patient in need thereof an effective amount of said pharmaceutical composition.

[0086] It must be noted that whilst many tumour types express tumour associated antigens, heterogeneity in the level of expression does occur, so some tumour cells may not be targeted by antibody and lysed directly. However, in vitro date from the analogous antibody-superantigen system shows that the high local levels of cytokines released by activated T cells can lead to the death of untargeted bystander tumour cells (Dohlsten et al, Int. J. Cancer 54, 1993, 482488). It is likely that similar effects will occur in a targeting system using MHC class I/peptide complexes. Similarly, it is possible that the presence of activated cytotoxic T cells releasing cytokines in the tumour may lead to enhancement of a specific anti-tumour immune response. Where the target cell is an APC and the HLA class I molecule or fragment thereof binds a tumour-specific peptide or any peptide which is exclusively or characteristically presented by HLA class I molecules on the surface of a virally, bacterially, parasitically or microbially infected cell, the pharmaceutical composition of the present invention may be used for immunising against the tumour or viral, bacterial, parasitic or microbial infection respectively, and there is provided a method of immunising against a tumour or viral, bacterial, parasitic or microbial infection in a patient, comprising the step of administering to a patient in need thereof an effective amount of said pharmaceutical composition.

[0087] The response of said patient may be improved by in vivo cytokine support, or by the infusion of antigen-specific cytotoxic T cells expanded ex vivo. Transient immunosuppression (Ledermann at al, Int. J. Cancer 47, 1991, 659664) may be used to minimise the immunogenic response of a patient to components of the targeting system such as the avidin bridge. The administration of said pharmaceutical composition may be by way of oral, sublingual, transdermal or parenteral administration.

[0088] Said effective amount of the pharmaceutical composition will depend on factors such as the nature and severity of the disorder being treated and on the weight, age and condition of the patient.

[0089] T Cell Receptor Genes

[0090] In addition to their direct use in therapy, the alloreactive CTLs of the present invention can also be used for cloning of their T cell receptor (TCR) genes. This is preferably accomplished by methods commonly used in the art e.g. PCR amplification and cloning of the TCR genes of the alloreactive CTLs.

[0091] The T cell receptor genes obtained in accordance with the present invention find application in gene therapy, for example using TCR transfer technology, as well as for making recombinant TCR molecules for therapy, and in any other techniques making use of cloned TCR gene(s).

[0092] Preferably when the recombinant TCR molecules are used in therapy, the Avidex technology is employed to produce soluble TCR molecules (see below).

[0093] Furthermore, the dismantling of the alloreactive T cell receptor, co-receptor, and binding site on appropriate cells into their component parts is advantageously carried out. These can then be modified, for example to discover new small molecule drug candidates.

[0094] Techniques are now available to produce stable, soluble, reproducible T cell proteins that provide the same range of opportunities as monoclonal antibodies did for the humoral immune system; new protein drugs, diagnostics, reagents of importance to the pharmaceutical industry, and improvement of existing drugs by site-directed targeting are therefore within the scope of the present invention through the alloreactive CTLs provided herein.

[0095] Thus, the alloreactive T cells of the present invention may be used for the production of T cell proteins, a key component of the body's immune system, as stable compounds suitable for a broad range of clinical applications. One way in which they may be so used is through recombinant DNA technology to clone the TCRs and produce them in vitro. This is preferably accomplished following the techniques from the teachings of Bent Jakobsen et al. (Institute of Molecular Medicine, University of Oxford), and the technologies stemming from and commercially available from Avidex Limited, Abingdon, Oxfordshire, UK.

[0096] Further Applications of Alloreactive CTLs

[0097] In addition to their direct use in therapy, the alloreactive CTLs of the present invention can also be used in vitro; for example in purging cell preparations of tumour cells such as bone marrow cells. Advantageously this may be accomplished in accordance with the methods of Gao et al. (Gao et al. 2000 Blood 95:2198-203).

[0098] The BQ cells described herein that recognize all A2/peptide complexes are also embraced by the present invention. These cells and their TCRs are useful, for example, in preventing organ transplant rejection as soluble TCRs that block all anti-HLA-A2 cells binding transplant organ cells. They may also be used for therapy of patients who develop allogeneic tumours after organ transplant, an unusual. but acute medical problem.

[0099] Starting Material

[0100] The methods of making CTLs described herein preferably begin with a sample of peripheral blood lymphocytes (PBLs/PBMCs). In a preferred aspect, the methods of making CTLs described herein do not involve comixing of the PBLs with any further cell(s) in vitro.

[0101] In a preferred aspect of the invention, these PBLs are chosen so that they are complementary to the HLA type of the intended recipient. For example, if the intended recipient is HLA-A2, then preferably the PBLs are HLA-A2 negative so that the strongest alloreactive CTLs are produced.

[0102] It is an advantage of the present invention that the APCs used are those that are present in the starting material PBLs. In this way, the comixing of other cell(s) with the CTLs is advantageously avoided.

[0103] Expansion/Proliferation of CTLs

[0104] Expansion/proliferation of CTLs is advantageously accomplished. In this embodiment of the invention, the proliferative cytokine may be a single cytokine or a combination thereof. Preferably the proliferative cytokine is a combination of IL-7 and IL-2.

[0105] Typically, the incubation period for expansion is about 7 days. Optionally, the incubation step is repeated for about 7 further days, and may be advantageously repeated for further time periods if desired, such as a further 7 days (e.g. 21 days in total) or even more.

[0106] It will be appreciated that the present invention relates to a CTL obtainable by the methods of the present invention. Thus the invention further relates to a method of treating a subject comprising administering a CTL obtainable by the methods of the present invention to said subject.

[0107] Preferably said CTL is directly obtained by the methods of the present invention. Thus the invention further relates to a method of treating a subject comprising administering a CTL obtained by the method of the present invention to said subject.

[0108] Treatment of a Subject

[0109] It is to be appreciated that all references herein to treatment include one or more of curative, palliative and prophylactic treatment. Preferably, the term treatment includes at least curative treatment and/or prophylactic treatment.

[0110] The treatment may be of one or more of cancer, tumour or related complaint. Treatment may be for producing/enhancing/augmenting immune response(s) in malignant illnesses such as cancer/leukaemia/lymphoma. Furthermore, treatment may be for infectious diseases including HIV and leprosy.

[0111] The CTLs of the present invention may be used as therapeutic agents—i.e. in therapy applications.

[0112] As with the term “treatment”, the term “therapy” includes curative effects, alleviation effects, and prophylactic effects.

[0113] The therapy may be on humans or animals.

[0114] In one aspect, CTLs are produced in vitro from donor PBLs according to the present invention. They are then expanded as described herein. Expansion may also be accomplished by any other suitable method known to those skilled in the art either in combination with or instead of the expansion techniques disclosed herein. Preferably, the expansion techniques are as disclosed herein.

[0115] Alloreactive peptide specific CTLs may then be introduced/administered into a subject. This may be by any suitable technique such as by infusion.

[0116] It will be appreciated that advantageously alloreactive CTLs from a single donor may be used to treat many different subjects. Preferably such subjects are HLA-A2 positive and the CTLs are HLA-A2 negative.

[0117] Administration

[0118] CTLs can be introduced into the subject using known methods, via various routes of administration and at various sites, e.g., renal subcapsular, subcutaneous, central nervous system (including intrathecal), intravascular, intrahepatic, intrasplanchnic, intraperitoneal (including intraomental), or intramuscular implantation. Typically, a physician or other health care provider or professional will determine the approximate cell dosage that will be most suitable for an individual subject. The specific dose for any particular subject may be varied and will depend upon a variety of factors including the age, body weight, general health, mode and time of administration and the severity of the particular condition in the subject undergoing transplantation.

[0119] The invention is now illustrated and further described by way of further examples, which should not be regarded as limiting in scope.

EXAMPLES Example 1

[0120] The following components were used:

[0121] Target cells: A human melanoma cell line Mel 1, deposited at the Department of Immunology, Institute of Molecular Medicine, Oxford, that carries the HLA class I allotype HLA-A2. The cell line was grown in standard RPMI tissue culture media. A human melanoma cell line Mel 2, deposited at the Department of Immunology, Institute of Molecular Medicine, Oxford, that does not carry the HLA class I allotype HLA-A2. The cell line was grown in standard RPMI tissue culture media.

[0122] Attaching means: A monoclonal antibody 225.28s (Buraggi 1985 Cancer Res. 45 3378-3387) that binds to the HMW-MAA antigen on human melanoma cells. Biotin is chemically conjugated onto this antibody as described in Bayer 1990, Methods Embryology 184, 138-160.

[0123] Pure hen egg avidin obtained commercially from Societa Prodotti Antibiotics, Milan, Italy.

[0124] HLA: Biotin conjugated recombinant HLA class I allotype HLA-A2 molecules, as described in Altman 1996, Science 274, 94-96, further containing the “gag” peptide that is part of the HIV virus. This peptide comprises the amino acid sequence-SLYNTVATL-. Methods for the preparation/isolation thereof are described in Johnson 1991, J Immunol 147, 1512. The “gag” peptide was attached to the HLA-A2 molecules as described in Garboczi 1992, PNAS 89, 3429-3433.

[0125] T cells: HLA-A2/gag specific cytotoxic T cells obtained from an A2+ve HIV patient as described in Altman 1994, Science 274, 94-96.

[0126] In order to establish the ability of the attaching means to cause display of the HLA class I molecules on the surface of Mel 2 target cells, approximately 200,000 cells were first incubated with biotin conjugated monoclonal antibody 225.28s at a final concentration of 20 μg/ml at 37° C. for 30 minutes. Following this the cells were washed in tissue culture media (RPMI 1640, obtainable from Gibco, Scotland). The Mel 2 cells were then incubated with avidin at a final concentration of 10 μg/ml for 10 minutes at 37° C. and washed in tissue culture media. Finally, the Mel 2 cells were incubated with biotin conjugated HLA class I HLA-A2/gag molecules at a final concentration of 20 μg/ml at 37° C. for 20 minutes.

[0127] The binding of recombinant HLA-A2 to the treated Mel 2 cells was shown by the attachment of anti-HLA-A2 monoclonal antibody BB7.2 (Santos-Aguado 1988; J. Immunol 141, 2811-2818) following incubation with BB7.2 antibody at a final concentration of 10 μg/ml at 37° C. for 30 minutes. After washing in tissue culture media the cells were incubated with phycoerythrin conjugated rabbit anti-mouse antibody (Sigma, Poole, UK) at a final concentration of 10 μg/ml for 30 minutes at 37° C. and analysed in a Becton Dickson Facscan machine. The result of this analysis is shown in FIG. 2 which demonstrates a positive signal indicating the presence of HLA-A2 molecules attached to the surface of the Mel 2 cells.

[0128] A chromium release T cell cytotoxicity assay was then performed in order to establish the ability of HLA-A2/gag specific T cell clones to lyse Mel 1 cells coated with HLA-A2/gag in accordance with the present method. Approximately 10⁶ Mel 1 cells were first pre-incubated with 1.85 μBq Na₂ ⁵¹Cr0₄ (obtained from Amersham International, Amersham, UK) for 1 hour at 37° C. The pre-incubated Mel 1 cells were then incubated with biotin conjugated monoclonal antibody 225.28s at a final concentration of 20 μg/ml at 37° C. for 30 minutes, and washed in tissue culture media. Following this, the Mel 1 cells were incubated with avidin at a final concentration of 10 μg/ml for 10 minutes at 37° C. and then washed again in tissue culture media. The Mel I cells were then incubated with biotin conjugated HLA class I HLA-A2/gag molecules at a final concentration of 20 μg/ml at 37° C. for 20 minutes and washed with tissue culture media.

[0129] Having been coated with HLA class I HLA-A2/gag, the chromium-treated Mel I cells were then incubated with HLA-A2/gag specific cytotoxic T cells in ratios of 0:1 to 20:1 of effector to target cells at 37° C. for 20 hours. Lysis of Mel I cells treated with Na₂ ⁵¹CrO₄ results in the release of radioactive chromium, which may be detected by analysis in a scintillation counter. In order to establish the percentage of Mel 1 cells lysed following incubation with HLA-A2/gag specific cytotoxic T cells, the following measurements were taken: background release of chromium from the Mel I cells in media alone (“M”); release of chromium from the Mel 1 cells following incubation with the T cells (“E”); release of chromium from the Mel I cells following final treatment with 5°//o Triton X-100 detergent (“T”). Treatment with detergent will cause the lysis of all the remaining intact Mel 1 cells.

[0130] % Mel 1 lysis by cytotoxic T cells was calculated as follows: ${\% \quad {lysis}} = {100 \times \frac{\left( {E - M} \right)}{\left( {T - M} \right)}}$

[0131] This analysis was carried out on Mel 1 cells treated with biotin-conjugated 225.28s, avidin, and biotin-conjugated HLA-A2/gag. As a control, the analysis was also carried out on Mel 1 cells treated with biotin-conjugated 225.28s and avidin alone, and on Mel 1 cells treated with avidin and biotin-conjugated HLA-A2/gag alone.

[0132] The key results of this analysis are illustrated in FIG. 3, which indicates that significant lysis (20%) of Mel 1 cells by HLA-A2/gag specific cytotoxic T cells occurs only when the Mel 1 cells have been treated with all the components of the attaching and delivery means of the present invention (ie biotin-conjugated 225.28s monoclonal antibodies, avidin, and biotin-conjugated HLA-A2/gag). No significant increase in cell lysis over background levels was observed in either of the control runs.

Example 2

[0133] The following components were used:

[0134] Target cells: The Daudi B cell line (MHC class I-negative), melanoma line SK-mel29 (HLA-A2.1-positive), 0.221/A2 (HLA-A2.1-positive), were maintained in RPMI media with 10% fetal calf serum and antibiotics in a 37° C. incubator with 5% CO₂.

[0135] Attaching means: Monoclonal antibodies 225.28s (Buraggi 1985 Cancer Res. 45 3378-3387) and 2147 that bind to the I-IMW-MAA antigen. Biotin is chemically conjugated onto these antibodies as described in Bayer 1990, Methods Embryology 184, 138-160.

[0136] Pure hen egg avidin obtained commercially from Societa Prodotti Antibiotici, Milan, Italy.

[0137] HLA : Biotinylated complexes of recombinant MHC class I and peptide were produced as described previously. (Altman et al, Science 274, 1996, 94-96; Ogg et al, Science 279, 1998, 2103). Prokaryotic expression of B2M and MHC class I heavy chain, modified by the C terminal addition of a target sequence for the biotin ligase enzyme BirA, was followed by inclusion body purification. Following refolding of heavy chain and B2M around specific peptide, complexes of 45 kD were isolated by gel filtration, biotinylated overnight using BirA in the presence of ATP, Mg2+ and biotin, and then purified by gel filtration and anion exchange.

[0138] T cells: Human cytotoxic T cell clones 010 (specific for HLA-A2/gag 77-85=SLYNTVATL (Parker et al, J Immunol. 149. 1992, 3580-3587)) and IF9 (specific for HLA-A2/melan-A 26-35=EAAGIGILTV (Romero et al, J. Immunol. 159, 1997, 2366) were maintained in media supplemented with 5% human serum and IL-2 100 IU/ml.

[0139] The stability of the MHC class I/peptide complexes was first established by an ELISA assay. Various MHC class I/peptide complexes, including HLA-A2/Gag3Y, HLA-A2/Gag3F, HLAA2/Lmp2, HLA-B35/Env and HLA-B35/nef, were prepared as outlined above, and were pre-incubated at 10 μg/ml in tissue culture media for 0-20 hours at 37° C. ELISA plates were coated with the mAb W6/32 (5 ug/ml in carbonate buffer pH 9.6 overnight at 4° C.) which recognises conformationally correct MHC class I molecules (Parham, 1979), and then blocked by incubation in 1% bovine serum albumin for 2 hours at 37° C. The MEC class I/peptide complexes were incubated for 30 minutes with the ELISA plates at room temperature, and binding was detected with rabbit anti-human B2 microglobulin followed by alkaline phosphatase conjugated goat anti-rabbit immunoglobulin, and substrate. All incubations were separated by extensive washes in PBS.

[0140] Absorbances at 600 nm were measured in a Titertek Multiscan ELISA reader. Three assays were performed for each sample, and the mean reading was calculated.

[0141] The results obtained with samples preincubated for 0, 1, 4, 16 and 20 hours are shown in FIG. 5. The results demonstrate that the HLA-A2/gag complexes have appreciable stability in culture media at 37° C., with an estimated half-life in excess of 24 hours.

[0142] In storage at 0.5-1 mg/ml at 4° C. HLA-A2/gag complexes appear to be stable for at least 12 months.

[0143] To demonstrate the ability of the attaching means to cause display of MHC class I on the surface of Daudi cells, Daudi cells deficient in MHC class I were sequentially incubated at 4° C. with biotinylated anti-CD20 (Ancell, Nottingham, UK; mAb 2H7 (Berenson et al, Blood 67, 1986, 509-515) at 1 μg/ml for 30 minutes); hen egg avidin (S. P. A., Milan, Italy, at 10 μg/ml for 10 minutes); biotinylated HLA-A2/gag (at 10 μg/ml for 10 minutes); and FITC labelled anti-MHC class I (Ancell, Nottingham, UK; mAB 3FI0 (Eisenbarth et al, J. Immunol. 124, 1980,1237-1244) at 10 μg/ml). Parallel controls omitted one or other incubation. Cells were washed 3 times in PBS between stages and then fixed in PBS plus 2% formaldehyde and analysed by flow cytometry.

[0144] Cells incubated with all three layers of the labelling system had high levels of detectable MHC class I/peptide on their surface compared to untreated Daudi cells (FIG. 6). Cells treated with only any 2 components of the 3-step system gave fluorescence levels comparable to untreated cells.

[0145] A chromium release cytotoxicity assay was carried out to establish the ability of specific T cell clones to lyse Daudi or SK-mel-29 cells in accordance with the present invention. Daudi or SK-mel-29 cells were incubated with ⁵¹CrO₄ at 2uCi/uL for 1 hour at 37° C. and then sequentially incubated with: the biotinylated mAbs 2H7 or 225.28s (anti-HMW-MAA) respectively; avidin; and biotinylated HLA-A2/gag complexes as detailed above. Peptide pulsed target cells were incubated with gag 77-85 or melan-A 26-35 peptides at 0.1 uM for 1 hour at 37° C. After washing, labelled target cells were plated into 96-well round bottom plates at 2,500 cells per well, followed by human CTLs at various effector:target ratios. Following incubation at 37° C., 20ul of supernatant was collected and the amount of ⁵¹Cr released was determined. The percentage of cytotoxicity (lysis) obtained at each effector:target ratio was calculated as: 100×(E−M)/(T−M), where E=Experimental release, M=Release in media and T=Release in 5% Triton X-100 detergent.

[0146] The results shown in FIG. 7 are the mean of experiments performed in duplicate. As shown by these results, the CTL clone (010) efficiently lysed HLA-A2-positive targets (0.221/A2) only when these were pre-incubated with the HLA-A2/gag peptide. MHC class I-negative Daudi cells, when targeted with the HLA-A2/gag complexes of the present invention, were recognised and Iysed by this CTL clone to an equivalent degree. Untargeted Daudi cells and cells targeted with only 2 of the 3 components of the targeting system were not recognised (maximal lysis <4°/a at E:T ratios of up to 80:1).

[0147] Control CTL, showing a different HLA-A2-restricted specificity (HLA-A2/melan-A), did not lyse Daudi cells targeted with the HLA-A2/gag complexes (FIG. 8), demonstrating the fine specificity of the targeting approach.

[0148] Untreated Daudi cells pulsed with gag peptide alone were not lysed by clone 010 (data not shown), in keeping with their lack of endogenous MHC class I.

[0149] The ability of antibody-directed HLA-A2/gag complexes to sensitise the melanoma cell line SK-mel29 to lysis by HLA-A2/gag-specific CTL line is shown in FIG. 8. At all E:T ratios, melanoma cells targeted by complexes linked to surface proteins were lysed substantially more than controls exposed to only two components of the 3-step targeting system. Additionally, MM9 melanoma cells that do not express HLA-A2 were also lysed in a similar manner (data not shown).

Example 3

[0150] Immunization/vaccination of a subject using HLA class I/peptide complex(es) to produce and/or amplify immune response(s) directed at particular cell surface molecule(s) may be accomplished according to the present invention. The immune response(s) thus produced are preferably directed at tumour cells which comprise the particular cell surface molecule(s) to which the immune response is produced. The form of this response is influenced by the particular HLA class I/peptide complex(es) used in the immunisation procedure(s).

[0151] In this example, use of antibody targeted HLA class I/peptide complexes to amplify a specific CTL response is demonstrated. Thus, example 3 also encompasses a method for delivering HLA class I/peptide complexes to the surface of antigen presenting cells.

[0152] In brief, it is demonstrated that biotinylated HLA-A2/peptide complexes immobilised on the surface of an antigen presenting cell via an antibody bridge cause the activation, amplification and expansion of cytotoxic T cells (CD8+ve) reactive with this specific HLA class I/peptide combination.

[0153] Materials and Methods

[0154] The following components were used:

[0155] Daudi cells: a human B cell lymphoma line derived from a patient with Burkitts lymphoma. The cell line was grown in RPMI standard tissue culture media.

[0156] Peripheral Blood Cells: peripheral blood mononuclear cells from a donor previously demonstrated to be HLA-A2. These cells were separated from whole blood by differential centrifugation using Ficoll Hypaque and cultured in standard RPMI tissue culture media.

[0157]1C1R-A2 cells: an HLA class I negative, human B cell line transfected with the gene for HLA-A2. These cells were cultured in RPMI tissue culture media supplemented with G418 400 ug/ml.

[0158] Attaching means: B9E9-streptavidin fusion protein, a tetrameric recombinant monoclonal antibody that binds to the B cell antigen CD20 (Schultz et al Cancer Research 2000).

[0159] HLA class I/peptide complexes: biotin conjugated recombinant HLA class I allotype HLA-A2 molecules as described by (Altman 1996 (Science 274, 94-96)). These complexes can contain the choice of immunogenic peptides including the influenza matrix MI or EBV BMLF1 peptides. The complexes were obtained from ProImmune Ltd Oxford England.

[0160] FACs Analysis:

[0161] Methods:

[0162] 1. Confirmation of ability to target HLA-A2/M1 peptide complexes to surface of B cells.

[0163] To confirm the ability of this system to target HLA-A2/M1 peptide complexes to the surface of B cells that can act as APCs, the HLA class I deficient Daudi B cell lymphoma line was used.

[0164] Approximately 1 million Daudi cells were first incubated with B9E9-SA diluted to 10 ug/ml in PBS for 1 hr at room temperature.

[0165] Following this the cells were washed twice in PBS and then incubated with biotinylated HLA-A2/MI diluted to 1ng/ml in PBS for 1 hr at room temperature.

[0166] The cells were then washed and placed back in a small tissue culture flask containing 5mls of RPMI and incubated at 37° C. in a 5% CO₂ atmosphere.

[0167] The binding and time course of the residence of recombinant HLA-A2 on the cell surface of the targeted Daudi cells was demonstrated by FACs analysis.

[0168] At various time points treated Daudi cells were removed, washed in PBS and incubated for 30 minutes at room temperature with an FITC labelled anti-HLA class I monoclonal (Ancell Ltd) antibody diluted to 10 ug/ml in PBS.

[0169] After washing in PBS the cells were analysed on a Becton Dickinson FACscan machine.

[0170] 2. In vitro immunisation procedure.

[0171] 30 mls of whole blood was obtained from a healthy volunteer (previously documented by tissue typing to be HLA-A2 +ve). Peripheral blood mononuclear cells were isolated by centrifugation using Ficoll-Hypaque.

[0172] Cells were then washed in PBS and then incubated with the B9E9 anti-CD20 streptavidin fusion protein at 10 ug/ml for 1 hr at room temperature.

[0173] The cells were then washed in PBS×2, and then incubated with the HLA-A2/peptide combination of choice at a concentration of 0.5 ug/ml for 1 hr at room temperature.

[0174] After a further wash in PBS the cells were placed in to 24 well plates at 2×10⁶ cells per well cultured in RPMI+10% FCS (heat inactivated)

[0175] On day 1 IL-7 was added to a concentration of 20 ng/ml. On day 4 and every subsequent 3 days IL-2 was added to a concentration of 10 U/ml.

[0176] The cells were incubated in a 37° C. incubator with 5% CO₂ for the duration of the experiment.

[0177] Various controls were also set up using this method including;

[0178] PBMCs alone,

[0179] PBMCs with the B9E9 antibody,

[0180] PBMCs without the B9E9 antibody but with free HLA-A2/peptide complex.

[0181] 3. Measurement of the induction/amplification of CTL activity.

[0182] The effect of the in vitro immunisation procedure on inducing the expansion of specific cytotoxic lymphocytes was assessed by two different modalities. The functional chromium release assay and the more recently described use of fluorogenic HLA-class I tetramers that specifically stain cells with the desired T cell receptor specificity.

[0183] a. Fluorogenic HLA class I Tetramer assay.

[0184] Samples from these same cells were analysed by tetramer assay. In brief, 3×10⁵ cells were washed in PBS and then re-suspended in 100 uL of PBS. 1 uL of an HLA-A2/peptide tetramer (ProImmune, Oxford England) was added per sample and incubated for 1 hr at room temperature. The cells were then washed in PBS and then incubated at room temperature for 1 hr with a FITC conjugated monoclonal antibody to CD8. (Dako) After further washing in PBS the cells were fixed in a 1% solution of formaldehyde in PBS and analysed on a Becton Dickinson FACscan machine.

[0185] The results are shown in FIG. 11.

[0186] b. The ⁵¹Cr release assay.

[0187] This assay follows standard laboratory methods. In brief CIR-A2 cells were labelled with radioactive Chromium (2uCi/ml) by incubation for 1 hr at 37° C. in a solution of ⁵¹Cr (Amersham). The cells were then washed and then ‘pulsed’ with a choice of immunogenic peptides at a concentration of 20 uM or no peptide at all for the negative controls. Alternatively Daudi lymphoma cells were used as target cells. Daudi cells were coated with HLA-A2/M1 monomers by first incubating with the B9E9-streptavidin fusion protein (10 ug/ml) for 1 hr at room temperature.

[0188] After washing in PBS biotinylated HLA-A2/M1 peptide complexes were added at 1 ng/ml and then incubated for 1 hr at room temperature. Following further washing the cells were used as targets in the CTL assay. These cells were then added to round bottom 96 well plates and various numbers of the cells produced form the ‘in vitro immunization’ procedure added to give the required ‘effector:target’ ratios.

[0189] After incubation for 4 hours at 37° C., 50 uL of the supernatant was removed and the amount of ⁵¹Cr released from lysed CIR-A2 or Daudi cells was estimated using a scintillation counter. The results are shown in Tables 8 and 9.

[0190] Results and Discussion

[0191] 1. Demonstration of the binding and prolonged residence of HLA-A2/M1 peptide complexes targeted to CD20+ve cells via the B9E9 fusion protein.

[0192]FIG. 10. Demonstrates the time course for the retention of the HLA-A2/M1 peptide complexes bound via the B9E9/SA fusion protein to Daudi B cells.

[0193] The results demonstrate that the binding of the HLA class I/peptide complexes via the B9E9 fusion protein results in their immobilisation on the surface of these cells.

[0194] The sequential FACs analyses demonstrate an increase in signal resulting from the bound HLA class I/peptide complexes at time 0 hrs compared to the native cells. This increase over background reduces with time but is still positive after 72 hrs incubation.

[0195] 2. Demonstration by Tetramer analysis of the expansion of specific CTLs via the binding of HLA-A2/peptide complexes to B cells via CD20

FIG. 11

[0196] Introduction

[0197] The results of the tetramer analysis are shown in FIG. 11 in both graphical (scatterplot) and numerical form. The value of the X axis varies with the degree of tetramer bind whilst the Y axis varies with the degree of binding of the monoclonal antibody to CD8. Each dot represents an individual cell that has. both an X and Y value.

[0198] The cursors are set to produce cut-off values resulting in the formation of 4 quadrants.

[0199] The cells in the bottom left quadrant are judged as being negative for CD8 and tetramer binding. The cells in the left upper quadrant are positive for CD8 but negative for tetramer. The cells in the lower right quadrant are positive for tetramer but negative for CD8. The cells in the upper right quadrant are positive both for CD8 and tetramer staining, these cells are the cytotoxic T cells (CTLs) the specificity as defined by the tetramer.

[0200] 1. Targeting of HLA Complexes

[0201] This experiment was performed using the HLA-A2/M1 peptide complex molecule in monomeric form for the in vitro immunization and in tetrameric form for the tetramer analysis.

[0202] Results

[0203] Sample A1

[0204] These are the results from PBMCs incubated without the B9E9 fusion protein or any biotinylated HLA-A2/peptide complexes. Here only 0.089% of all the CD8+ve cytotoxic lymphocytes in the sample have specificity for the HLA-A2/M1 tetramer.

[0205] Sample A2

[0206] These are the results from PBMCs incubated with the B9E9 fusion protein but without the addition of any biotinylated HLA-A2/M1 complexes. Here 0.0287% of all the CD8 +ve cytotoxic lymphocytes in the sample have specificity for the HLA-A2/M1 tetramer.

[0207] Sample A3

[0208] These are the results from PBMCs incubated with the B9E9 fusion protein and with the addition of the biotinylated HLA-A2/M1 complexes.

[0209] Here 2.19% of all the CD8 +ve cytotoxic lymphocytes in the sample have specificity for the HLA-A2/M1 tetramer.

[0210] Sample A4

[0211] These are the results from PBMCs incubated without the B9E9 fusion protein but with the addition of the biotinylated HLA-A2/M1 complexes.

[0212] Here only 0.197% of all the CD8 +ve cytotoxic lymphocytes in the sample have specificity for the HLA-A2/M1 tetramer.

[0213] Further exemplary results may be found in FIG. 11.

[0214] These results show that by immobilising HLA class I/peptide complexes on to the surface of an antigen presenting cell (in this example a B lymphocyte, via a streptavin conjugated monoclonal antibody fusion protein with specificity for CD20) that a specific cytotoxic T cell response can be induced as detected by tetramer analysis.

[0215] This effect is seen when the complexes are immobilised on the cell surface—PBMCs incubated in an identical way (with IL-7 and Il-2) produce no effect (A1), neither does binding of the B9E9 fusion protein alone (A2) or the addition of free HLA class I peptide complexes (A4).

[0216] A further experiment was performed that looked at the specificity of the response to the ‘in vitro immunization’ procedure using two different HLA class I/peptide combinations and their respective tetramers.

[0217] 2. In vitro Immunisation Experiment

[0218] Similar in vitro immunizations of PBMCs were set up using the following combinations of the B9E9 fusion protein and HLA-A2/M1 and HLA-A2/BMLF1 complexes.

[0219] C/PBMCs with B9E9 but without any HLA-A2/peptide complex

[0220] F/PBMCs with B9E9 and with the HLA-A2/M1 complex

[0221] I/PBMCs with B9E9 and with the HLA-A2/BMLF1 complex

[0222] After 10 days incubation tetramer analysis using the anibody to CD8 and the PE conjugated tetramers HLA-A2/M1 and HLA-A2/BMLF1 were performed.

[0223] Results

[0224] The results of the dual staining were; CD8 + ve CD8 + ve and and M1 tetramer + ve BMLF1 tetramer + ve Sample C 0.021% 0.048% Sample F 0.254% 0.074% Sample I 0.095%  3.80%

[0225] These results show that the immune response from CTLs as measured by tetramer analysis is specific to the identity of the HLA class I/peptide complex used in the ‘in vitro immunization’.

[0226] In sample C which had no HLA class/peptide complex added the level of cells staining positive for CD8 and tetramer is low 0.021% for the HLA-A2/MI tetramer and 0.048% for the HLA-A2/BMLF1 tetramer.

[0227] Sample F had the HLA-A2/MI peptide complex immobilized on the B cells via B9E9 during the ‘in vitro immunization’ and here the level of HLA-A2/M1 tetramer positive cells has increased over 10 fold to 0.254% whilst the HLA-A2/BMLF1 tetramer posive cells are similar to sample C at 0.074%.

[0228] The ability of the HLA-A2/BMLF1 peptide complex when immobilised on the B cells via the B9E9 fusion protein to specifically expand CTLs reactive with this peptide is shown in the results of Sample I. Here the numbers of CD8 +ve cells reactive with the HLA-A2/M1 tetramer is 0.095%, which is similar to the unstimulated sample C, however now 3.80% of the CD8+ve cells bind the HLA-A2/BMLF1 tetramer, an approximately 80 fold increase in relative number.

[0229] Further exemplary results may be found in FIG. 11.

[0230] These results support the dislcosure of Experiment 1 (targeting experiment; see also predecessor applications) that the immobilised HLA class I/peptide complexes can induce a CTL response and further demonstrate that the response is specific for the HLA-classI/peptide combination. The immobilised HLA-A2/MI complex produces an expansion in CTLs that bind the HLA-A2/MI tetramer, whilst the immobilised HLA-A2/BMLF1 complex produces an expansion in CTLs that bind the HLA-A2/BMLF1 tetramer. There appears to be little non-specific activation of CTLs of the other specificity although some modest expansion may be expected due to the release of cytokines within the cell culture.

[0231] 3. Demonstration by cytotoxicity ⁵¹Chromium release analysis of the expansion of specific CTLs via the binding of HLA-A2/peptide complexes to B cells via CD20 according to the present invention.

[0232] The chromium release assay is another method for reading out T cell activity and can give information on the functional capability of CTLs. Target cells (in this case CIR-A2 or Daudi) cells are labelled with radioactive ⁵¹Chromium and then incubated with varying numbers of ‘effector’ cells that have been produced by the ‘in vitro immunization’ procedure with the PBMCs described above.

[0233] After incubation (usually 4 hours) a sample of the cell supernatant is taken and assayed for the presence of radioactive ⁵¹Cr which has been released from the target cells as a result of the action of specific cytotoxic lymphocytes in the effector cell population.

[0234] The Daudi cells do not express any HLA class I molecules on their cell surface. However if HLA class I /peptide complexes are attached to their surface via a monoclonal antibody they can serve as effective targets for CTLs (Ogg et al 2000).

[0235] The CIR-A2 cells serve as targets, they only possess one HLA class I allele the A2 molecule and the exact specifity of this can be altered by placing a peptide of choice within the peptide binding grove by ‘peptide pulsing’ in vitro. After performing peptide pulsing the target cells have on their cell surface of the HLA-A2 molecules a high proportion containing the peptide of choice and so form a reliable and reproducible target for CTLs of this specificity.

Targeted Lysis Experiment

[0236] The results are expressed in terms of the degree of lysis of the target cells during the ⁵¹Cr release assay.

[0237] This is calculated according to this equation;

[0238] % lysis is calculated as: $100\quad \% \times \frac{E - M}{T - M}$

[0239] Where, E=experimental release

[0240] M=Media release

[0241] T=Maximal release in 5% Triton 100

[0242] The ability of the following PBMC preparations to lyse Daudi cells ‘coated’ with HLA-A2/M1 peptide complexes at an E;T ratio of 10:1 was;

[0243] Sample A1

[0244] These are the results from PBMCs incubated without the B9E9 fusion protein or any biotinylated HLA-A2/peptide complexes.

[0245] Sample A2

[0246] These are the results from PBMCs incubated with the B9E9 fusion protein but without the addition of any biotinylated HLA-A2/M1 complexes.

[0247] Sample A3

[0248] These are the results from PBMCs incubated with the B9E9 fusion protein and with the addition of the biotinylated HLA-A2/M1 complexes.

[0249] Sample A4

[0250] These are the results from PBMCs incubated without the B9E9 fusion protein but with the addition of the biotinylated HLA-A2/M1 complexes.

[0251] Results TABLE 8 Results of a T cell chromium release assay using HLA class I negative Daudi B cell lymphoma cells as targets. These cells were coated with HLA-A2/M1 peptide complexes attached via the anti-CD20 B9E9-streptavidin fusion protein. The % Lysis of HLA-A2/M1 coated Daudi cells by PBMCs stimulated +/− HLA-A2/M1 complexes A1 =  8% A2 = 10% A3 = 24% A4 = 10%

[0252] These results demonstrate that the treatment of PBMCs with the B9E9-streptavidin fusion protein and biotinylated HLA-A2/M1 peptide complexes in accordance with the present invention results in the amplification of the CTL response to HLA-A2/M1 as measured in this assay. PBMCs treated with both parts of the system (A3) produced 24% lysis whilst the lysis produce by untreated PBMCs (A1), or PBMCs treated with the B9E9 fusion protein alone (A2) or PBMCs treated with free HLA-A2/M1 complexes produced a maximum of only 10% lysis.

Specific Amplification Experiment

[0253] To demonstrate that the amplification of CTL response is specific to the identity of the HLA class I/peptide combination, the experiment was repeated with two HLA-A2/peptide specificities.

[0254] The results of this show differing patterns of activity for PBMCs treated with B9E9 fusion protein and the two differing HLA-A2/peptide complexes or for those treated without any HLA-A2 peptide complexes.

[0255] In this experiment CIR-A2 cells (native or peptide pulsed) were used as target cells.

[0256] The figures given are the percent lysis of peptide pulsed target cells. (E:T ratio, 5:1). TABLE 9 Results of a T cell chromium release assay using CIR-A2 target cells that had been ‘pulsed’ with either nothing or the flu M1 or EBV BMLF1 peptides as indicated. The effector cells were cultured from peripheral blood cells, of an HLA-A2 + ve healthy donor, incubated with the anti-CD20 B9E9-streptavidin fusion protein alone and HLA-A2/M1 or HLA-A2/BMLF1 complexes. Immunization protocol: B9E9-SA + B9E9-SA + B9E9-SA + Nil HLA-A2/M1 HLA-A2/BMLF1 Targets (sample C) (sample F) (sample I) CIR-A2 + Nil 5.3% 11.9% 10.7% CIR-A2 + MI 4.8% 13.6% 10.2% CIR-A2 + BMLF1 7.3% 16.4% 23.7%

[0257] In this experiment it is again demonstrated that PBMCs that are just targeted with the B9E9 molecule do not produce any significant lysis of target cells either native CIR-A2 or peptide pulsed with the M1 or BMLF1 peptides.

[0258] PBMCs targeted with B9E9 and HLA-A2/M1 complexes produced a weak response in this particular experiment without any clear pattern of enhanced lysis.

[0259] PBMCs targeted with B9E9 and HLA-A2/BMLF1 complexes produced CLS that had enhanced activity against CIR-A2 cells pulsed with BMLF1 (23.7%) but no increased lysis against either native CIR-A2 cells (10.7%) or CIR-A2 cells pulsed with M1 peptide (10.2%).

[0260] These results further illustrate the production of a CTL response that is predominantly against the HLA class I/peptide complex which is immobilised on the surface of the antigen presenting cell according to the present invention (in this Example, B cells via CD20 using B9E9 fusion protein).

[0261] Summary

[0262] The data in this document demonstrate that HLA-class/peptide complexes when immobilised on the surface of an antigen presenting cell via an antibody bridge result in the amplification of the immune response to that specific HLA-class/peptide complex.

[0263] The ability to specifically produce amplification of cytotoxic T cell numbers and/or activity to a particular HLA class 1/peptide combination is an advantageous feature of the present invention.

[0264] The system(s) described herein offer considerable possibilities as methods for producing/enhancing/augmenting immune response(s) in malignant illnesses such as cancer/leukaemia/lymphoma. Furthermore, these systems may find application in infectious diseases including HIV and leprosy.

Example 4 In vivo Cancer Cell Therapy

[0265] In certain embodiments, the invention relates to using anti-viral CTLs in therapeutic approaches to combat tumour/cancer cells.

[0266] In this example, it is demonstrated that anti-viral Cytotoxic T cells inhibit the growth of cancer cells bearing antibody targeted MHC class I/peptide complexes in SCID mice.

[0267] In the present invention, cytotoxic T cells (CTLs) of non-tumour specificity are redirected against cancer cells. It is demonstrated herein that cancer cells targeted with recombinant HLA-class I/peptide complexes via an antibody delivery system can be effectively lysed by anti-viral CTLs in vitro. Furthermore, this example demonstrates effects in vivo in a mammalian system.

[0268] This system uses the recombinant anti-CD20 B9E9 sfvSCSA fusion protein to target HLA-A2/M1 complexes to CD20+ve Daudi lymphoma cells. Binding of the B9E9 sfvScSA fusion protein to Daudi cells in culture had no apparent effect on growth kinetics. Using an HLA-A2/M1 specific human T cell clone, in vitro killing of targeted Daudi cells was achieved with HLA class I concentrations as low as 5 pg/ml. A tumour protection assay using human CTL to the HLA-A2/M1 complex was performed in SCID mice. Applicant demonstrates that only 1 of 4 mice receiving Daudi cells targeted with both the B9E9 sfvSCSA fusion protein and the HLA-A2/M1 complex developed tumours, whilst in the control mice with receiving CTL but native Daudi cells 4 of 4 developed tumours, as did 4 of 4 receiving targeted Daudi cells but no CTLs.

[0269] This demonstration of the in vivo activity for the combination of targeted HLA class I/peptide complexes and anti-viral T cells, demonstrates the effectiveness of the antibody HLA class I targeting system. Clearly, this system may be advantageously combined with autologous CTLs produced by vaccination or ex vivo expansion.

[0270] This example also embraces aspects of the delivery (targeting) system. This example further illustrates a useful model system.

[0271] The B cell surface antigen CD20 serves as a good target for this system as it is expressed on many B cell malignancies, remains on the cell surface for days and is not internalised on antibody binding. Monoclonal antibodies to CD20 are available and are well characterised (Hainsworth 2000). Recombinant antibody fragments have also been developed. The tetravalent B9E9 sfvScSA fusion protein (see Schultz et al 2000) is useful as a targeting system.

[0272] To demonstrate the abilities of human CTLs of anti-viral specificity to interact with tumour cells targeted with HLA-A2/peptide complexes in a physiological setting, a model was developed as explained below.

[0273] Severe combined immunodeficient (SCID) mice are capable of supporting functional human CTLs for periods, possibly requiring a degree of cytokine support (de Kroon J. et al 1997, Buchsbaum et al 1996)

[0274] The human B cell lymphoma Daudi cell line can grow as a xenograft in SCID mice without requiring further routine immunosuppression and has been used in a variety of of therapeutic systems (see Gidlof et al 1997, Ghetie et al 1996).

[0275] This example demonstrates the in vivo interaction of human anti-viral CTLs and HLA targeted Daudi cells in a tumour protection experiment.

[0276] Cell lines:

[0277] Clone 25—A human cytotoxic T cell clone with specificity for HLA-A2/M1 was maintained in RPMI with 10% AB serum and antibiotics.

[0278] Daudi B cell lymphoma—A CD 20 +ve human B cell lymphoma cell line that is deficient for the expression of HLA class I. Daudi cells were maintained in RPMI media supplemented with 10% FCS and antibiotics in a 37° C. incubator with 5% CO₂.

[0279] Antibodies:

[0280] Anti MHC class I (W6/32) Fitc conjugated (Sigma)

[0281] B9E9 sfvscSA. A recombinant tetravalent scFV/streptavidin fusion protein with specificity for CD20 (Schultz et al, 2000)

[0282] Mice:

[0283] Male SCID mice aged 6-8 weeks were maintained in sterile conditions in a suitable animal facility.

[0284] Facs analysis:

[0285] Becton Dickinson FACscan machine with relevant software.

[0286] Methods

[0287] Action of B9E9 scFvSA on Daudi cell growth

[0288] Daudi cells were washed in PBS and then incubated with dilutions of the B9E9 scFvSA in PBS for 1 hour at room temperature. After two washes the cells were resuspended in 5 mls of tissue culture media and incubated at 37° c. in a 5% CO2 atmosphere. The proliferation of the antibody treated cells and controls was assessed by sequential counts of the viable cells using Trypan blue exclusion and a haemocytometer.

Effect of HLA Dilutions on In Vitro CTL Mediated Lysis:

[0289] Standard Chromium release assays were performed using the Daudi B cell line as the target cell. Briefly, cells were labelled with 100 uCi of ⁵¹Cr (Amersham Pharmacia) for 1 hr at 37° C. After washing in PBS, cells were incubated with B9E9 at 10 ug/ml for 1 hr at room temperature. After two further washes cells were incubated with dilutions of HLA-A2/M1 complexes in PBS for 1 hour at 4° C. After 2 further washes the cells were plated out at 3000 cells per well in U-bottomed 96 well plates. Tissue culture media, dilutions of CTLs or 5% Triton X-100 were added to a final volume of 200 uL. Plates were incubated for 4 hours at 37° C. in a 5% CO2 atmosphere and then 50 uL of supernatant collected and added to 150 uL of scintillant in a standard scintillation plate and counted.

[0290] The specific lysis was calculated as; ${\% \quad {lysis}} = {\frac{{{experimental}\quad {cpm}} - {{spontaneous}\quad {cpm}}}{{{maximum}\quad {cpm}} - {{spontaneous}\quad {cpm}}} \times 100}$

[0291] The spontaneous release was measured from the cells incubated in media alone, the maximum release was measured from the cells incubated in Triton.

[0292] FACS analysis was performed on the cells targeted with B9E9 sfvScSA fusion protein and HLA-A2/M1 prepared as above. Samples of cells were washed in PBS and then incubated with FITC labelled-anti-MHC class I (Ancell, Nottingham UK) and analysed by flow cytometry on a Becton Dickinson FACscan.

In Vivo Tumour Protection Assay

[0293] Healthy male SCID mice aged 6-8 weeks were used for the tumour protection assay. Four mice were used in each of the 3 groups A, B and C, treated as follows;

[0294] Group A

[0295] Mice in Group A were injected IP with 3×10⁶ clone 25 cells in 0.2ml of sterile PBS on Day 1. On Day 2 1×10⁶ Daudi cells targeted sequentially, ex vivo, with B9E9 sfvFSA (10 ug/ml) and HLA-A2/M1 (0.5 ug/ml) were injected IP in 0.2ml of sterile PBS.

[0296] Group B

[0297] Mice in group B were injected IP with 3×10⁶ clone 25 cells in 0.2ml of sterile PBS on Day 1. On Day 2 1×10⁶ native Daudi cells were injected IP in 0.2ml of sterile PBS.

[0298] Group C

[0299] Mice in group C were injected with 0.2ml of sterile PBS on Day 1. On Day 2 1×10⁶ Daudi cells targeted sequentially, ex vivo, with B9E9 sfvFSA (10 ug/ml) and HLA-A2/M1 (0.5 ug/ml) were injected IP in 0.2 ml of sterile PBS.

[0300] The mice in all 3 groups received IP injections with human IL-2 (Chiron) 2,500 U in 0.1 ml PBS daily on days 1-3.

[0301] Following these procedures the mice were maintained in sterile conditions and monitored for tumour development. All mice were sacrificed at day 60 and assayed for tumour development.

Effects of B9E9 SFVSCSA Binding on Daudi Cell Kinetics in vitro:

[0302] To investigate the possibility of any apparent effect on cell kinetics from the binding of the B9E9 sfvSA fusion protein to the Daudi lymphoma cells a simple in vitro study was performed. The results from this shown in Table 10 show the growth over 4 days of the cells treated with dilutions of B9E9 sfvScSA and the untreated control cells. The rates of proliferation for the native and antibody bound cells appear comparable with no significant effect on the growth of the Daudi lymphoma cells in culture resulting from B9E9 sfvScSA binding. TABLE 10 Effects of B9E9 sfvSA binding to Daudi cell growth kinetics in vitro. (Results expressed as cells × 10⁴/ml) Day 0 Day 1 Day 2 Day 3 Day 4 Expt 1 (B9E9) 19.3.01 Daudi + nil 20 27 33 51 — Daudi + 0.1 ug/ml 20 34 33 54 — Daudi + 1 ug/ml 20 23 33 76 — Daudi + 10 ug/ml 20 26 27 76 — Expt 2 (B9E9) 9.4.01 Daudi + Nil 20 22 29 36 71 Daudi + 10 ug/ml 20 11 17 32 70

Dose Response of HLA Binding Concentration (Measured by FACS Signal and Cr Release Assay):

[0303] To investigate the effects of varying of the concentration of biotinylated HLA class I molecules delivered to the target cells a dose response was obtained using FACs analysis and Cr release assays as shown in Table 11.

[0304] The results indicate that a positive signal could be obtained by FACs with concentrations of biotinylated HLA down to approximately 1-5 ng/ml. The functional chromium release assay show that effective lysis of target cells can occur when exposed to concentrations of biotinylated HLA class as low as 5 pg/ml, which is producing levels of HLA binding that are significantly below the level of FACs detection. TABLE 11 HLA-A2/M1 complex concentration/ml FACs (Gm) ⁵¹Cr Nil 5.8  2% 10 μg 18.98 n/d 1 μg 22.54 n/d 0.1 μg 18.41 n/d 10 ng 8.47 42% 5 ng 7.40 n/d 1 ng 5.71 51% 0.5 ng 5.8 50% 0.1 ng 4.6 42% 50 pg — 34% 10 pg — 22% 5 pg — 18% 1 pg —  1%

In Vivo Tumour Protection Assay

[0305] The ability of anti-viral CTLs to interact with cancer cells targeted with the HLA-class I peptide complexes was assayed in a tumour protection assay in SCID mice. After inoculation of the tumour cells the animals were monitored and sacrificed at day 60 when signs of disease became apparent. After sacrifice the mice were dissected and the tumour tissue weighed.

[0306] The results of the 3 groups were:

[0307] Group A (Day 1 Clone 25, Day 2 Daudi+B9E9+HLA-A2/M1)

[0308] 1) Tumour mass 2.4 g

[0309] 2) No tumour

[0310] 3) No tumour

[0311] 4) No tumour

[0312] Group B (Day 1 Clone 25, Day 2 Daudi-native)

[0313] 1) Tumour mass 5.64 g

[0314] 2) Tumour mass 0.66 g

[0315] 3) Tumour mass 1.54 g

[0316] 4) Tumour mass 2.36 g

[0317] Group C (Day 1 PBS, Day 2 Daudi+B9E9+HLA-A2/M1)

[0318] 1) Tumour mass 3.78 g

[0319] 2) Tumour mass 1.50 g

[0320] 3) Tumour mass 3.06 g

[0321] 4) Tumour mass 3.47 g

[0322] Thus, use of the cellular immune system to selectively attack cancer cells according to the present invention has been demonstrated.

[0323] There are an increasing number of tumour associated peptides described that may serve to immunologically distinguish cancer from normal cells, and may therefore be useful in targetting aspects of the present invention. Particularly suitable are tumour specific or tumour associated cell surface antigens that can be bound by monoclonal antibodies. A number of these antibodies are now available, and could be adapted to deliver complexes of the present invention to the surface of tumour cells.

[0324] The production of large numbers of CTLs reactive with viral epitopes useful in the present invention is relatively easy in vivo as a result of infection by the relevant virus(es) and/or vaccination with said viral epitope(s). These CTLs may even be prepared/supplied ex vivo by specific antigenic stimulation.

[0325] The use of antibody targeted HLA class I/peptide complexes to redirect the lytic action of CTLs having anti-viral specificity against tumour cells according to the present invention is demonstrated. Antibody targeted HLA class I tetramers may be used, and a range of tumour cells targeted may be effectively killed by anti-viral CTLs. These aspects of the present invention are further illustrated by the in vivo data presented herein.

[0326] The applicant has advantageously reduced the number of targeting steps to two in this example by the use of the B9E9-sfvScSA fusion protein.

[0327] To investigate if binding of B9E9 to the Daudi cells used in the in vivo examples had any effect itself on said cells, the applicant examined the effects of binding B9E9 on cell growth. The results shown in Table 10 demonstrate that there was no significant effect on cell growth. Thus, without wishing to be bound by theory, the effects observed clearly flow from the methods of the present invention, and not from a mere effect of antibody binding.

[0328] The results shown in Table 11 demonstrate that significant lysis of tumour cells occurs in vitro even at very low concentrations of the biotinylated HLA class I/M1 complex. Only at levels of 50 pg/ml or below does the degree of lysis begin to reduce slightly and activity is maintained down to 5 pg/ml. The very high affinity of biotin-streptavidin interaction (10⁻¹⁵M) means that binding takes place efficiently even at these low concentrations. In a clinical scenario, with possible difficulties of targeting access, a possible degree of antigen shedding and possibly a relatively short half-life of 3 polypeptide chain types of recombinant HLA class I molecules, this advantageous feature of the present invention (ie. the ability to produce functionally effective targeting at low HLA concentrations and/or to produce effective CTL mediated lysis with only relatively small numbers of molecules immobilised on each target cell) may be very valuable.

[0329] Function of the system in vivo is demonstrated. Of the animals pre-treated with the anti- HLA-A2/M1 CTL clone 25 and then injected with targeted Daudi cells, only 1 of the 4 developed a tumour. In contrast, the control groups (i.e. either mice pre-treated with clone 25 but receiving-native Daudi cells, or mice with no CTL pre-treatment receiving targeted Daudi cells), all 4 of each group developed tumours.

[0330] Thus, it is demonstrated that anti-viral CTLs can effectively interact in vivo with these cells and are effectively targeted with antibody targeted HLA class I/peptide complexes according to the present invention.

[0331] The low toxicity of the targeting antibody and of the recombinant HLA class I peptide complexes demonstrates that sufficient molecules may be delivered to target cells, facilitating effective CTL activity according to the present invention.

[0332] HLA stability may advantageously be improved by the production of single chain recombinant versions.

[0333] Production of CTLs by vaccination, or the administration of CTLs expanded ex vivo such as described for the treatment of EBV associated lymphoma (Savoldo et al 2000) may be advantageously employed in the present invention. TABLE 12 Clone 25 Clone 25 Clone 12 HLA cone E:T 8:1 E:T 10:1 E:T 5:1 10 ug/ml 91% 5 ug/ml 38% 1 ug/ml 69% 100 ng/ml 69% 10 ng/ml 46% 97% 42% 1 ng/ml 75% 85% 51% 0.5 ng/ml — 79% 50% 0.1 ng/ml 49% 87% 42% 0.05 ng/ml — — 34% 0.01 ng/ml 27% 44% 22% 0.005 ng/ml — 26% 18% 0.001 ng/ml 13% 12.8%   1.4% 

Example 5 Induction of Viral and Tumour Specific CTL Responses using Antibody Targeted HLA Class I Peptide Complexes.

[0334] Introduction

[0335] A central aim of cancer immunotherapy is the induction of effective cytotoxic T cell activity that recognises HLA class I/peptide complexes that are either. specific to or over-represented on tumour cells (Rosenberg, 1996). There is increasing evidence that low levels of CTLs specific for ‘tumour’ peptides are present in a number of malignancies (Pittet et al, 1999), however the magnitude of these pre-existing responses frequently appears to be insufficient for effective in vivo activity.

[0336] The interaction between the HLA class I/peptide complex and the T cells antigen receptor is the final pathway in the expansion of CD8+ve CTLs. A range of approaches aim to reach this interaction, starting with either defined tumour associated peptide or more complex cellular based preparations. These methods include vaccination with peptides (Rosenberg et al, 1998), naked DNA (Mincheff et al, 2000) or irradiated tumour cells (Chan and Morton, 1998), these systems rely on processing and presentation by native antigen presenting cells (APCs). Alternatively ex vivo expanded dendritic cells can be used either with peptide pulsing (Hsu et al, 1996, Brossart et al, 2000), loading with tumour lysate (Nestle et al, 1999) or transfected with genes encoding tumour proteins (Wang B et al, 2000). Recombinant HLA-class I/peptide complexes either immobilised on beads (Lone et al, 1998, Tham et al, 2001), incorporated into antibody based fusion proteins (Cullen et al, 1999), or as recombinant MHC tetramers (Wang T et al, 2000) have also produced effective CTL responses both in vitro and in pre-clinical models.

[0337] Dendritic cells are the most effective APCs but are present in low numbers in vivo and are difficult to culture, in contrast B cells are present in large numbers, are simple to manipulate in vitro and have been demonstrated to act effectively as APCs inducing specific CTL responses in vivo (Gajewski et al, 2001).

[0338] In a previous example we demonstrate that HLA class I/viral peptide complexes targeted to B cells via an antibody delivery system can serve as effective targets for the lytic action of anti-viral CTLs (see also Ogg et al, 2000, Savage et al, 2002). In this example we have used a similar system to investigate if the 2-step antibody delivery system (see FIG. 12) is able to produce the specific expansion of CTLs of chosen specificities from unselected populations of PBMCs.

[0339] Materials and Methods

[0340] Antibodies:

[0341] The B9E9 scFvSA fusion protein contains the single-chain variable region of the murine

[0342] IgG2a anti-CD20 murine antibody B9E9 fused to the genomic streptavidin of Streptomyces avidinii. The protein is secreted into the periplasm of genetically engineered E. coli as monomeric subunits (43,400 Daltons) that spontaneously fold into soluble tetramers with a molecular weight of 173,600 Daltons. The four antigen-binding and biotin-binding sites of the fusion protein retain the functional capabilities of the parent molecules (Schultz et al, 2000). The FITC conjugated monoclonal antibodies used in flow cytometry were anti-MHC class I (W6/32) (Cymbus Biotechnology, Harrow, UK), anti-CD19, anti-CD80 and anti-CD86 (Dako, Ely, UK).

[0343] Cells:

[0344] The CIR-A2 (Storkus et al, 1989) and Daudi (Klein et al, 1968) cell lines were grown in RPMI+10% FCS supplemented with Penicillin and Streptomycin in a 37° c. incubator with 5% CO₂. PBMCs were isolated from healthy volunteers and melanoma patients previously documented to be HLA-A2+ve. Approximately 30 mls of venous blood was obtained by venepuncture and unfractionated PBMCs were obtained by differential centrifugation using Histopaque (Sigma, Poole, UK).

[0345] HLA-A2/peptide complex monomers and tetramers:

[0346] Recombinant HLA-A2 class I molecules were obtained from ProImmune Ltd, (Oxford Science Park, Oxford UK). In brief, recombinant HLA -A2 heavy chain and beta-2 microglobulin were produced in E. Coli. The functional HLA class I/peptide complex were produced by refolding around the peptide of choice and then biotinylation via the Bir A site on the HLA heavy chain. (Garboczi et al, 1992, Altman et al, 1996)

[0347] The peptides used in these experiments were Influenza virus M1 peptide GILGFVFTL (Gotch et al, 1987), Epstein-Barr virus (EBV) BMLF1 peptide GLCTLVAML (Steven et al, 1997) and the modified melanoma associated Melan A peptide ELAGIGILTV (Valmori et al 1998). The PE conjugated fluorescent HLA-A2/peptide tetramers of the same specificities used for flow cytometric analysis were also obtained from ProImmune.

[0348] Methods

[0349] Targeting of B9E9 scFvSA and HLA-A2/Peptide Complexes to HLA Class I −ve B Cells.

[0350] HLA class I -ve Daudi cells were used to investigate the binding of the HLA-A2/class I peptide complexes via the B9E9 scFvSA. Cells were washed in PBS and incubated with B9E9 scFvSA diluted in PBS at 10 ug/ml for 1 hour at RT. After washing the cells were incubated with either biotinylated HLA-A2/M1 peptide complexes at 0.5 ug/ml or PBS alone for 30 minutes at RT. After further washing the two groups of cells were resuspended in RPMI+10% FCS and grown at 37° C. in a 5% CO₂ atmosphere. At various time points parallel samples of cells were removed, washed and incubated for 30 minutes at RT with FITC conjugated W6/32, after washing the cells were analysed by flow cytometry.

[0351] The Effects of B9E9 scFvSA Binding on the Expression of Co-stimulatory Molecules in PBMC B Cells.

[0352] PBMCs prepared by differential centrifugation were incubated with B9E9 scFvSA (10 ug/ml), IL-7 (10 ng/ml), B9E9 scFvSA and IL-7 or PBS alone for 1 hour at RT. After washing the cells were placed into tissue culture media and returned to culture at 37° C. Samples were removed and double stained with PE conjugated anti-CD19 and either FITC conjugated anti-CD80 or anti-CD86 and analysed on a Becton Dickinson FACScan using FACScomp software.

[0353] In Vitro Immunisation Protocol

[0354] PBMCs were incubated with the B9E9 scFvSA (10 ug/ml) diluted in PBS for 1 hour at RT. After washing cells were incubated with the biotinylated HLA class I/peptide complex (0.5 ug/ml in PBS) for 30 minutes at RT. Various controls, omitting the B9E9 scFvSA or the HLA class I/peptide complex were also performed. After washing, cells were placed into 24 well plates at 3×10⁶ cells per well and cultured in RPMI with 10% human AB serum. IL-7 (R and D Systems, Minneapolis, Minn.) was added on day 1 at 10 ng/ml and IL-2 (Chiron, Harefield, UK) was added at 10 U/ml on day 4 and every further 3 days following the method described by Lalvani (Lalvani et al, 1997). In the experiments with a second stimulation cycle further PBMCs were obtained and treated as above. These new cells were then mixed with the existing culture at a 1:2 ratio and the culture continued for a further 8 days.

[0355] Flow Cytometry and Tetramer Analysis

[0356] To stain CD8+ve cells from the PBMC culture approximately 1×10⁶ cells were washed in PBS, resuspended and incubated with tetramer solution for 30 minutes at 37° C. followed by FITC conjugated anti-CD8 for 20 minutes at 4° C. After incubation the cells were washed, resuspended in PBS and analysed by dual colour flow cytometry. The results of flow cytometry analysis of dual stained PBMCs are shown with anti-CD8 (Y axis) and HLA-A2/M1 tetramers (X axis). Percentage figures relate to the number of tetramer positive CD8 +ve cells from the total CD8+ve population.

[0357] Chromium Release Assay

[0358] Daudi or CIR-A2 cells were labelled with 2 uCi/uL of ⁵¹Cr (Amersham Pharmacia, UK) for 1 hr at 37° C. then washed. Daudi cells were sequentially coated with B9E9 sfvScSA and HLA-A2/M1 complexes following the method above whilst CIR-A2 cells were pulsed with the peptide of choice at a concentration of 10 uM for 1 hr at 37° C. The target cells were plated at 3000 cells per well in U bottomed 96 well plates. PBMCs, media or 5% Triton X-100 were added to a final volume of 200 ul. Plates were incubated for 4 hours at 37° C. in a 5% CO₂ atmosphere and 5 ul of supernatant was collected and added to 150 ul of scintillant.

[0359] The specific lysis was calculated as: ${\% \quad {lysis}} = \frac{{{experimental}\quad {cpm}} - {{spontaneous}\quad {cpm} \times 100}}{{{maximum}\quad {cpm}} - {{spontaneous}\quad {cpm}}}$

[0360] The spontaneous release was measured from the cells incubated in media alone, the maximum release was measured from the cells incubated in 5% Triton.

[0361] Results

[0362] 1. Sequential analysis of the binding of biotinylated HLA-A2/M1 complexes to Daudi B-cell lymphoma cells via B9E9 scFvSA.

[0363] The time course of the retention of the targeted HLA-A2/M1 complexes retention the HLA class I −ve Daudi cells is demonstrated in the sequential flow cytometry analyses in FIG. 13. An increased fluorescence signal is demonstrated in the targeted cells which decreases with time. However a positive signal is still maintained at +72 hours and it is probable that HLA class I/peptide complexes persist at functional levels beyond this time.

[0364] 2. Effects of B9E9 scFvSA binding on the expression of co-stimulatory molecules in PBMC B cells.

[0365]FIG. 14 demonstrates that the addition of B9E9 sfvScSA has no detectable effect on the expression of CD80 or CD86 on the B cells within the PBMC population. The results show the flow cytometry results for CD19+ve cells at 3 hrs and 24 hrs. PBMCs treated with IL-7 alone or the combination of B9E9 sfvScSA and IL-7 also demonstrated no change in the levels of expression of CD80 and CD86.

[0366] 3a) Induction of CTL activity with targeted HLA class I/peptide complexes.

[0367] The ability of the antibody targeted complexes to stimulate CTL expansion was initially examined with the HLA-A2/M1 combination. In FIG. 15 the tetramer analysis of the CD8+ve/HLA-A2/M1 positive cells within the unstimulated PBMCs (1), PBMCs targeted with the B9E9 sfvScSA (2), and PBMCs exposed to free soluble HLA-A2/M1 complexes at 0.1 ng/ml (3) demonstrate values of 0.06% to 0.22%. In contrast the PBMCs targeted with the B9E9 sfvScSA and HLA-A2/M1 complexes (4) demonstrated 2.33% tetramer positive CD8+ve cells. Using the unfractionated PBMCs at E:T 10:1, a 4 hour Cr release assay, using HLA-A2/M1 coated Daudi cells as target cells, demonstrated a maximum of 10% lysis from the 3 control experiments but 24% from the PBMCs stimulated with HLA-A2/M1 complexes attached via the B9E9 sfvScSA fusion protein.

[0368] 3b) Induced CTL responses are specific for the targeted complex.

[0369] To confirm the specificity of CTL expansion, PBMCs were targeted with either B9E9 sfvScSA alone (A) or B9E9 sfvScSA and HLA-A2/BMLF1 complexes (B).

[0370] In FIG. 16 the tetramer analysis of the PBMCs targeted with B9E9 sfvScSA alone demonstrates background staining of 0.04% with HLA-A2/M1 and 0.09% with HLA-A2/BMLF1. In the Cr release assay against CIR-A2 cells either native or pulsed with M1 or BMLF1 peptide the PBMCs showed no significant activity. In contrast PBMCs targeted with the HLA-A2/BMLF1 complexes demonstrate 2.99% staining with the HLA-A2/BMLF1 tetramer but with only a background staining level of 0.01% with the HLA-A2/M1 tetramer. These cells produced 20% lysis of the BMLF1 pulsed CIR-A2 target cells without any significant action on native or M1 pulsed cells.

[0371] 3c) CTL responses to a single cycle of stimulation with HLA-A2/peptide complexes in healthy donors and melanoma patients.

[0372] The numerical values of the tetramer results from PBMCs from a series of healthy donors and melanoma patients are demonstrated in Table 13.

[0373] In response to stimulation with targeted HLA-A2/M1 complexes a greater than 5 fold increase in the number of tetramer+ve cells are seen in 6 of the 8 volunteers and one of two melanoma patients. From the HLA-A2/BMLF1 stimulated cells one of the 5 volunteers showed a greater than 5 fold increase with 2 others showing apparent increases. In response to targeted HLA-A2/Melan A complexes greater than 3 fold increases in tetramer positive cells were seen in 3 of 4 volunteers and in one of the melanoma patients. TABLE 13 HLA-A2+M1 (2^(nd) and 3^(rd) columns) + BMLF1 (4^(th)and 5^(th) columns) + MelanA (6^(th) and 7^(th)columns) Don 0 1 0 1 0 1 RT 0.21 1.08 0.54 0.63 — — SL 0.04 0.41 0.28 0.26 — — JaR 0.00 0.32 0.30 0.85 — — LO 0.00 0.01 0.08 0.31 — — LL 0.09 2.20 0.09 2.99 0.06 0.26 CJ 0.16 0.57 — — 0.04 0.13 JuR 0.07 0.52 — — 0.09 0.08 DV 0.07 0.80 — — 0.03 0.14 BB* 0.00 0.22 — — 0.41 1.33 DB 0.36 0.91 — — 0.42 0.21

[0374] 3d) CTL responses to HLA-A2/M1 and Melan A can be enhanced by a repeated stimulation

[0375]FIG. 17 demonstrates the CTL responses produced by 2 rounds of in vitro stimulation using the same HLA-A2/peptide complex. The 4 hr Cr release assay (E:T 20:1) demonstrates that PBMCs stimulated with targeted HLA-A2/M1 complexes on both day 1 and day 8 produce 14% lysis of the CIR-A2 M1 pulsed cells compared with 3% lysis of native and 6% lysis of CIR-A2 melanA pulsed cells. The increase in HLA-A2/M1 specific CTLs is shown in the tetramer series with 0.09% from unstimulated cells (1A), 0.68% after one cycle (1B) and 2.32% after two cycles (1C). In this donor similar results were seen with responses to melan A with a 15% lysis of CIR-A2 cells pulsed with the Melan A peptide and increases in tetramer staining from a background of 0.06%, 0.16% after one cycle and 1.40% after two cycles. In this experiment cycles subject to one cycle of stimulation did not produce detectable activity in the Cr release assay.

[0376] Discussion

[0377] The induction of an effective immune response against malignant cells has been an aim of cancer research for over a century. With the increasing understanding of how the immune system may differentiate between normal and malignant cells a number of cancer vaccine approaches have been examined. To date many of these have centred on the use of undefined antigens via tumour cell lysates or irradiated cells. However with the identification of a number of potential tumour peptide epitopes (Boon and van der Bruggen, 1996, Vonderheide et al, 1999) and the ease. of manufacture of recombinant HLA class I peptide complexes (Garboczi et al, 1992) it is now feasible to consider highly specific approaches to cancer vaccine strategies.

[0378] Purified immobilised HLA class I/peptide complexes have been shown to interact and stimulate CTLs when attached to tissue culture plates (Kane et al, 1989), chemically attached to cells (Anjeure et al, 1995, Walter et al, 1997) or when coated onto beads (Motta et al, 1998). More recently antibody targeted HLA class I/peptide complexes have been demonstrated to successfully interact with CTLs to permit lysis of targeted cells in vitro (Ogg et al, 2000, Robert et al, 2000).

[0379] The ability of B cells targeted with HLA class I/peptide complexes to induce CTL responses is clearly shown in FIGS. 15, 16 and 17. In vitro CTL responses demonstrated by tetramer and Cr release assays were obtained when the HLA class I/peptide complexes were targeted to PBMCs pre-treated with the B9E9 sfvSA fusion protein. In contrast free HLA class I/peptide complexes produced no apparent responses indicating a requirement for either multimerisation or immobilisation of HLA class I/peptide complexes for effective CTL stimulation as previously described (Motta et al, 1998, Abastado et al, 1995).

[0380] The specificity of the CTL expansion is confirmed by the results shown in FIG. 16 where increases in tetramer staining and lysis of peptide pulsed target cells was only seen in response to stimulation with that specific HLA/peptide complex.

[0381] The ability of this system to further increase responses by repeated stimulation is shown in the tetramer stain results of FIG. 17. Here the frequencies of CTLs reactive with HLA-A2/M1 increase from 0.09% to 2.32% after a second cycle. In this donor the MelanA results of 0.06% and. 1.4% show as similar pattern, with positive Cr release assays after 2 cycles.

[0382] The efficiency of CTL induction, has previously been shown to be related to the stability and length of expression of the HLA class-I complex on the surface of antigen presenting cells (van der Burg et al, 1996, Micheletti et al, 1999, Valmori et al, 1998). In this antibody targeting system we have aimed to optimise the time course for expression of the HLA class I complexes, by using complexes with long half lives and a high affinity binding system to a non-intemalising B cell marker. The ability of these complexes to persist in a conformationally correct form for at least 72 hours on the surface of the B cells is demonstrated in FIG. 13. It is probable that functionally active levels of complexes remain on the surface of the B cells for a longer period, we have previously shown that CTLs interact efficiently with B cells with levels of targeted HLA below that detectable by cytometry (Savage et al, 2002).

[0383] The data in FIG. 14 demonstrates that binding of the B9E9 sfvScSA to the B cells within the PBMCs either alone or in conjunction with IL-7 had no effect on the expression of B80 and B86. Whilst the enhanced expression of co-stimulatory molecules generally increases CTL responses, it has previously been demonstrated that effective CTL can be produced without accessory molecule expression, particularly when high epitope densities are used (Wang et al, 2000).

[0384] At present there has been only limited optimisation of this in vitro stimulation protocol with significant differences in the levels of CTL responses between individuals. However in all experimental cultures using targeted HLA class I/peptide complexes significant inhibition of proliferation compared to those targeted with the B9E9 fusion protein alone was observed (data not shown). It is possible that the effect of the supra-physiological stimulation prevents expansion of the specific CTL population either via a direct apoptotic action or the result high levels of cytokine production within the closed system. Studies in mice have shown that increased antigenic density can result in higher CTL activity but produces a significant reduction at very high densities (Wherry et al, 1999). Similarly in human systems the presence of supra-optimal levels of HLA class I complexes can lead to apoptosis rather than expansion of stimulated CD8+ve CTLs (Alexander-Miller et al, 1998). As CD20 is present at approximately 50,000 copies per B cell (Marti et al, 1992), saturated binding of HLA class I/peptide complexes could result in 50,000-200,000 copies of a single peptide/HLA class I combination per cell. This is significantly higher than produced by peptide pulsing which results in peptide placement in 5,000 copies of an individual HLA allele (Delon et al, 1998) out of a total allele number of 10⁵ per B cell. (Kageyama et al, 1995, McCune et al, 1975) Additionally the stability of the recombinant complexes appears to be greater than those produced by peptide pulsing which have an average {fraction (1/2)} life of only 2.5-4 hrs (Wataya et al, 2001) which may further increase the strength and duration of T cell activation.

[0385] The ability of this system to specifically induce the expansion of CTLs to a specific peptide/HLA-class I complex will prove useful for in vitro studies analysing the endogenous CTL response or the effects of other in vivo procedures. Potentially this system could also be used for the ex vivo production of CTLs for the adoptive immunotherapy of cancer and other diseases. However a vaccination procedure based on targeting HLA class I/peptide complexes to APCs in vivo via an antibody delivery system could offer significant advances in both the applicability and effectiveness of cancer vaccines.

[0386] The B9E9 sfvSA fusion protein is currently in clinical trials for the treatment of B cell lymphoma using radiolabelled biotin as the effector function. The ease of administration, lack of toxicity and option for repeated doses suggest that using this molecule in a vaccine strategy should be feasible. To date recombinant HLA class I molecules are yet to be administered to cancer patients, however as endogenous HLA class I molecules circulate in health and in increased levels in a number of illnesses (McMillan et al, 1997) they are unlikely to have any direct toxicity.

[0387] In this work we have focused on stimulation with a single HLA class I/peptide complex, however the ability to make these recombinant molecules of any chosen HLA class I/peptide combination should allow for vaccination with a range of complexes either sequentially or concurrently. As the stability of the HLA class I/peptide complexes appears to varying considerably with the identity of the peptide (Valmori et al, 1998) and stability is closely linked to the immunogenicity of a chosen HLA class I/peptide complex, it is possible that recombinant molecules that incorporate the peptide/ HLA heavy chain/beta-2-microglobulin into fusion proteins may offer potential benefits.

[0388] Currently optimisation of the level of targeted HLA class I/complexes on the targeted B cells and the cytokine support for the most effective stimulation and induction of CTL responses in vitro is being examined. Potential clinical studies will initially use PBMCs targeted with complexes ex vivo, which will allow accurate administration of designated numbers of targeted cells at the opyimum epitope density. Considering the potential clinical applicability of this system, it is probable that initially PBMCs will be targeted with complexes ex vivo, potentially via a closed leucapheresis system. This approach should also minimise the potential immunogenicity of the streptavidin in the fusion protein and the potential risk of uncontrolled CTL expansion that could occur with intravenous. HLA classI/complex administration that would result in the targeting of the total B cell population.

[0389] Summary

[0390] The production of cytotoxic T cells (CTLs) with specificity for cancer cells is a rapidly evolving branch of cancer therapeutics. A variety of approaches aim to amplify anti-tumour CTL responses using purified peptides, tumour cell lysates or recombinant HLA/peptide complexes in differing antigen presenting systems.

[0391] Using a two-step biotin-streptavidin antibody targeting system, recombinant HLA-class I/peptide complexes were attached to the surface of B cells via the anti-CD20 B9E9-scFvSA antibody-streptavidin fusion protein. Flow cytometry with a conformation dependant monoclonal antibody to HLA class I indicated that targeted HLA-class I/peptide complexes remain on the surface of B cells in culture for periods in excess of 72 hours. PBMCs were stimulated in vitro for 8-14 days using the autologous B cells as antigen presenting cells. Following a single cycle of stimulation specific CTL responses to targeted HLA-A2 complexes containing the M1, BMLF1 and Melan A peptides could be demonstrated by tetramer staining and Cr release assays. With the HLA-A2/BMLF1 complex up to 2.99% of CD8+ve cells were tetramer positive producing 20% lysis (E:T 10:1) of CIR-A2 target cells in an in vitro cytotoxicity assay compared to baseline levels of 0.09% tetramer +ve and 2% lysis in the unstimulated population.

[0392] PBMCs from a healthy donor treated with two cycles of stimulations with targeted HLA-A2/Melan A complexes, demonstrated expansion of the melanA tetramer+ve population from 0.03% to 1.4% producing 15% lysis of Melan A pulsed target cells.

[0393] With further consideration to the key variables of HLA/peptide complex density, the ratio of stimulator to effector cells and optimum cytokine support, this system should offer an easy and effective method for the in vitro amplification of specific CTL responses and warrants development for the in vivo induction of CTL responses in cancer therapy.

Example 6. Treatment of a Blood Sample

[0394] Protocol for the ex vivo preparation and re-administration of autologous B cells treated with antibody targeted HLA class I/peptide complexes.

[0395] 1) Take 600 ml of venous blood into standard transfusion bag

[0396] 2) Transfer to blood transfusion laboratory for work in sterile GLP conditions

[0397] 3) Centrifuge to prepare ‘buffy’ coat from 600 mls of whole blood

[0398] 4) Wash in sterile PBS×1

[0399] 5) Resuspend in 50 mls sterile PBS

[0400] 6) Incubate with B9E9 sfvscSA at 10 ug/ml for 30 minutes at room temperature

[0401] 7) Wash in sterile PBS×3

[0402] 8) Resuspend in 50 mls sterile PBS.

[0403] 9) Incubate with biotinylated HLA class I/peptide complex(es) at 0.5 ug/ml for 10 minutes at room temperature.

[0404] 10) Wash in sterile PBS×1

[0405] 11) Resuspend in 50 mls of sterile PBS

[0406] 12) Re-infuse into patient via peripheral venous access over 10 minutes.

Example 7 Method for Producing Antipeptide Cytotoxic T Lymphocytes (CTLs)

[0407] Method

[0408] Purify PBLs from donor (HLA-A2−ve).

[0409] Mix with sfvSA (to CD20).

[0410] Add HLA-A2/peptide monomer.

[0411] Wash off excess.

[0412] Incubate for 7 days with IL-7 and IL-2.

[0413] Repeat after 7 days.

[0414] Results

[0415]FIG. 18 shows CTLs, according to the present invention, which are specific for HLA-A2/M1 (flu) and HLA-A2 Melan-A (melanoma) as measured after 0, 1 or 2 rounds of stimulation.

Example 8 Method for Producing Antipeptide Cytotoxic T Lymphocytes (CTLs)

[0416] An in vitro method to produce alloreactive CTLs against a designated HLA class I/peptide combination is demonstrated. In this Example, HLA-A2/Melan-A is used. FIG. 20 helps to illustrate this embodiment of the invention.

[0417] Method

[0418] PBLs from healthy HLA-A2 −ve donors were purified by Histopaque centrifugation.

[0419] B9E9 scFvSA were incubated in PBS at 10 g/ml for 1 hour at room temperature (RT) and then washed.

[0420] Biotinylated HLA-A2/Melan-A were complexed at 0.5 g/ml for 30 minutes at RT and then washed.

[0421] Cells were plated in 24 well plates at 3×10⁶ cells per well in RPMI with 10% AB serum.

[0422] IL-7 was added on day 1 at 10 ng/ml.

[0423] IL-2 was added at 10 U/ml on day 4 and every further 3 days.

[0424] Cells underwent 1, 2, 3 cycles of stimulation.

[0425] Read-out analysis by Tetramer/CD8 staining and ⁵¹Cr release assay using peptide pulsed T2 cells was performed.

[0426] Results

[0427]FIGS. 21 and 22 illustrate the efficient production and specificity of CTLs produced according to the present invention. FIG. 21 shows the increasing population of CTLs through cycles of stimulation from 0.12% at 0 cycles to 17.3% after 3 cycles. FIG. 22 shows specificity of CTLs according to the present invention for the target HLA-A2/peptide complex.

[0428] Thus it can be seen that the methods of the present invention produce high outputs of CTLs. It further demonstrates that CTLs produced according to the present invention exhibit excellent reactivity with the target complex.

Example 9 Production of Anti-tumour Alloreactive T Cells using Antibody Targeted HLA Class I/peptide Complexes

[0429] Outline

[0430] The effective production of CTLs that recognise clinically important HLA class I/peptide. combinations. is demonstrated herein.

[0431] Using recombinant HLA-A2 class I/peptide complexes targeted to autologous B cells of HLA-A2+ve donors, it is demonstrated that specific CD8+ve CTLs can be made from peripheral blood mononuclear cells (PBMCs). Using this technology to deliver HLAA2/peptide complexes to the surface of the B cells in PBMCs from HLA-A2 −ve donors, we have demonstrated the production of alloreactive CTLs against HLA-A2. Using PBMCs stimulated with targeted HLA-A2/Melan-A complexes, tetramer staining demonstrated that the HLA-A2/Melan-A tetramer positive proportion of the CD8+ve cells increased from 0.12% prior to stimulation to 15.1% after 3 weekly cycles of stimulation.

[0432] The specificity of alloreactive CTLs produced to HLA-A2/MelanA and HLA-A2/WT1 from two donors was demonstrated by staining with a panel of HLA-A2 tetramers.

[0433] From donor PS the CTLs produced to the HLA-A2/Melan-A and WT1 complexes only produced significant staining with the appropriate tetramer.

[0434] From donor BQ, the CTLs produced against HLA-A2/Melan-A stained only with that tetramer, but in contrast, the CTLs produced against HLA-A2/WT1 demonstrated comparable levels of binding to each of the panel of tetramers.

[0435] This difference in specificity was reflected in functional Cr release assays. Cells from donor PS showed a significant degree of specificity whilst the WT1 cells from donor BQ demonstrated no peptide specificity.

[0436] The ability to simply produce large numbers of alloreactive CTLs with targeted recombinant HLA class I/peptide complexes preferably to GMP standards offers a number of therapeutic and scientific possibilities. Thus the invention further relates to the production of alloreactive cells for adoptive immunotherapy, the cloning of T cell receptor genes from high affinity alloreactive CTLs, the screening of allograft donors for the ease and specificity of production of CTLs against designated targets and the investigation of the molecular mimicry between HLA class I/peptide complexes.

[0437] Background

[0438] In comparison to normal cells, malignant cells may have differences in the immunogenic peptides displayed within the peptide binding grove of their HLA class I molecules. These immunological differences give the potential for therapies based on enhancing specific T. cell mediated immune responses to these cells (Pardoll 2000). The increasing description of more tumour specific and tumour related HLA class I binding peptides is now further encouraging the development of T cell mediated immunotherapy directed against these defined targets (Rosenberg 1996).

[0439] In some malignancies, the existence of pre-existing low levels of CTLs reactive with a number of tumour related HLA class I/peptide combinations has already been demonstrated and these epitopes may be the most suitable for autologous cancer vaccine studies (Pittet 1999). However, due to immunological tolerance, it is difficult to produce autologous high affinity CTLs to many other HLA class I/peptide combinations.

[0440] A therapeutic approach of the present invention aimed at overcoming tolerance, is to make high affinity alloreactive anti-tumour CTLs which can recognise these targets (Sadovnikova 1998). This is demonstrated herein.

[0441] These CTLs are expanded for use in adoptive immunotherapy. They are also useful in gene delivery mediated immunotherapy using the cloned T cell receptor. (Gao 2000, Stanislawski 2001, Kessels 2001).

[0442] The clinical value of alloreactive anti-tumour CTLs can already be seen in leukaemia patients who receive donor bone marrow transplants. Here the production of an alloreactive CTL mediated graft versus leukaemia activity within the graft versus host activity is associated with an enhanced prognosis (Molldrem 2000) and currently a number of projects are in progress which aim to separate these two immunological effects.

[0443] As explained above, existing methods of production of alloreactive CTLs frequently rely on the use of antigen presenting cells. such as peptide pulsed T2 or HLA class I transfected Drosophila cells (Moris 2001 Sadovnikova 1998, Dutoit 2002). These systems have a number of limitations including; modest immunostimulatory actions, potential HLA mismatches at more than one allele, the lack of GMP standard reagents and also a lack of flexibility to present other than HLA-A2. In the autologous setting, antibody targeted HLA class I complexes delivered to B cells are effective in the production of autologous CTLs against the targeted complex (Savage et al 2002). In this example, application of antibody targeted HLA class I complexes to produce allorereactive CTL responses to HLA-A2/peptide complexes from PBMCs from non-HLA-A2 donors is described. (See FIG. 20.)

[0444] Materials and Methods

[0445] Antibodies and cells

[0446] The B9E9 anti-CD20 sfvscSA fusion protein (Schultz et al. 2001) was obtained from NeoRx Corp, Seattle USA.

[0447] HLA-A2+ve T2 (Salter 1985) cells were grown in RPMI+10% FCS supplemented with penicillin and streptomycin in a 37° C. incubator with 5% CO₂.

[0448] Venous blood was obtained from tissue typed healthy volunteers. (MG HLA A1, A1, B8, B44. PS HLA A3, A24, B35, B57. BQ HLA A1, A26, B7, B27). Unfractionated PBMCs were isolated by differential centrifugation using Histopaque (Sigma, Poole, UK).

[0449] HLA-A2/peptide complex monomers and tetramers

[0450] Recombinant HLA-A2 class I monomers and fluorescent tetramers were obtained from ProImmune Ltd. (Oxford Science Park, Oxford UK). The peptides used in these experiments were Influenza virus M1 peptide GILGFVFTL (Gotch et al. 1987), the modified melanoma associated Melan A peptide ELAGIGILTV (Valmori et al. 1998), the WT1 p126 peptide RMFPNAPYL (Oka et al. 2000 ), the telomerase p540 eTRT peptide ILAKFHWL (Minev et al 2000) and the HPV16 E7 11-20 peptide (YMLDLQPETT) (Ressing et al. 1995)

[0451] In vitro immunisation protocol

[0452] PBMCs were incubated with the B9E9 scFvSA (10 μg/ml) diluted in PBS for 1 hour at room temperature. After washing, cells were incubated with the biotinylated HLA class I/peptide complex (0.5 ug/ml in PBS) for 30 minutes at room temperature. After washing, cells were placed into 24 well plates at 3×10⁶ cells per well and cultured in RPMI with 10% human AB-serum. IL-7 (R and D Systems, Minneapolis, Minn.) was added on day 1 at 10 ng/ml and IL-2 (Chiron, Harefield, UK) was added at 10 U/ml on day 4 and every further 3 days, following the method described by Lalvani et al. (1997). For further stimulation cycles, fresh PBMCs were obtained and treated as above. These new cells were then mixed with the existing culture at a 1:2 ratio, and the culture was continued for a further 7 days.

[0453] Flow cytometry and Tetramer analysis

[0454] To stain CD8+ve cells from the PBMC culture, approximately 1×10⁶ cells were washed in PBS, resuspended and incubated with tetramer solution for 30 minutes at 37° C., followed by FITC conjugated anti-CD8 for 20 minutes at 4° C. After incubation, the cells were washed, resuspended in PBS and analysed by dual colour flow cytometry. The results of flow cytometry analysis of dual stained PBMCs are shown with anti-CD8 (y axis) and HLA-A2/M1 tetramers (x axis). Percentage figures relate to the number of tetramer positive CD8+ve cells from the total CD8+ve population.

[0455] Chromium release assay

[0456] T2 cells were labelled with 2 μCi/μL of ⁵¹Cr (Amersham Pharmacia, UK) for 1 hr at 37° C., and then washed and pulsed with the peptide of choice at a concentration of 10 μM for 1 hr at 37° C. The target cells were plated at 3000 cells per well in U bottomed 96 well plates. PBMCs, media, or 5% Triton X-100 were added to a final volume of 200 μl. Plates were incubated for 4 hours at 37° C. in a 5% CO₂ atmosphere and 50 μl of supematant was collected and added to 150 μl of scintillant.

[0457] The specific lysis was calculated as: ${\% \quad {lysis}} = {\frac{{{experimental}\quad {cpm}} - {{spontaneous}\quad {cpm}}}{{{maximum}\quad {cpm}} - {{spontaneous}\quad {cpm}}} \times 100}$

[0458] The spontaneous release was measured from the cells incubated in media alone, the maximum release was measured from the cells incubated in 5% Triton.

Example 9.1 Timecourse of Alloreactive CTL Production

[0459] In FIGS. 23aand 23 b, the tetramer staining results of PBMCs from Donor MG (HLA A1, A1, B08, B44) targeted with HLA-A2/Melan-A and HLA-A2/M1 complexes are demonstrated. These show increases in the number of HLA-A2/Melan-A tetramer positive CD8+ve cells from 0.12% pre-stimulation, through to 15.1% after 3 cycles. The results for HLA-A2/M1 are similar increasing from a background level of 0.13% through to 5.16% after 3 cycles.

[0460] In Table 14, the results from Donor PS (HLA A3, A24, B35, B57) and Donor BQ (HLA A1, A26, B7, B27) are included. These demonstrate similar levels of CTL production to the more stable HLA-A2/M1 and Melan-A complexes with an approximately 10 fold lower level of CTL production to the less stable HLA-A2/WT1 complex. TABLE 14 Frequencies of tetramer positive alloreactive CTLs to HLA-A2/M1/Melan-A/WT1 before and after 1-4 cycles of stimulation with targeted HLA-A2/peptide complexes. Donor (#cycles) HLA-A2/M1 HLA-A2/Melan-A HLA-A2/WT1 MG (×3) 5.2% 14.9% — BQ (×5) 3.1% (×3) 22.8% (×5) 0.74% (×5) PS (×4) — 15.9% 0.8% LH (×3) —  0.5% 1.4%

Example 9.2 Specificity of Tetramer Staining of Alloreactive CTLs from HLA-A2 −ve Donors.

[0461] The tetramer binding characteristics of the CTLs produced using the targeted HLA-A2 peptide/complexes were investigated with panel of 5 HLA-A2/peptide tetramers. The results from Donor PS, shown in FIG. 24, demonstrate that cells produced against both HLA-A2/Melan-A and HLA-A2/WT1 show significant staining only against the appropriate tetramer. In contrast, Donor BQ gives a different result. FIG. 8 shows that the CTLs produced from Donor BQ with HLA-A2/Melan-A show significant staining with only that tetramer, while the CTLs produced with HLA-A2/WT1 show similar levels (˜0.90%) of staining with all 5 tetramers.

[0462] PBMCs stained prior to stimulation or after 3-4 cycles of cytokine treatment alone showed staining to all tetramers of <0.15%.

Example 9.3 Functional Activity of Alloreactive CTLs from HLA-A2 −ve Donors.

[0463] The functional activity of the alloreactive CTLs contained within the PBMCs stimulated with targeted HLA-A2/peptide complexes was investigated in standard 4 hour Cr release assays using native and peptide pulsed HLA-A2+ve T2 target cells. The results from Donor PS are shown in FIGS. 26a and 26 b. The cells produced with the HLA-A2/Melan-A complex demonstrated a degree of functional specificity producing, at an E:T ratio of 10:1, 62% lysis of the T2 cells pulsed with the Melan-A peptide and from the control T2 cells a maximum lysis of 27%. Similar results are seen with CTLs produced with HLA-A2/WT1 with 61% lysis of the WT1 pulsed cells with levels of 29-41% seen for control T2 cells.

[0464] Control mock targeted PBMCs treated with weekly cycles of the anti-CD20 sfvSA antibody, cytokines but without HLA-A2/peptide complexes showed approximately 20% lysis of each of the peptide pulsed T2 cells at an E:T ratio of 10:1.

[0465] In FIG. 27a and 27 b the functional results of the alloreactive CTLs contained within the PBMCs from donor BQ are shown. The cells produced with HLA-A2/Melan-A show their highest activity of 28% against the Melan-A pulsed targets compared to a maximum of 24% with the other peptides. The cells produced with HLA-A2/WT1 demonstrate no peptide specificity with activity levels equivalent to the control mock targeted CTLs.

[0466] Summary

[0467] The ability to generate CTLs that have specificity for tumour cells as demonstrated herein is of enormous potential value in haematology and cancer immunotherapy.

[0468] In this Example, HLA-A2/peptide complexes are targeted to the surface of B cells of HLA-A2 −ve donors producing a powerful alloreactive stimulus to a single designated HLA class I/peptide combination. The ability of this system to quickly and simply produce large numbers of alloreactive CTLs is demonstrated in FIG. 23a and 23 b. Here for HLA-A2/Melan-A, a background level of 0.12% prior to stimulation rising to 0.13%, 0.66%, and 15.1% after 1, 2 and 3 rounds of stimulation is demonstrated. Similar results producing CTLs with the HLA-A2/M1 complex are demonstrated in FIG. 23b with 5.16% of the CD8+ve cells tetramer positive after 3 cycles of stimulation. These results compare positively with conventional T2 based technologies that produced 0.06% CD8+ve CTLs to HLA-A2/M1 after 10 days (Moris et al 2001). In Table 14, the additional results of further tetramer analyses of CTLs produced to these epitopes and to HLA-A2/WT1 in two other donors are shown.

[0469] The stability of the HLA class I/peptide complex has been shown to be important in the induction of CTL in vitro (Valmori 1999, Micheletti 1999). The results here of CTL production via the alloreactive route suggest a similar effect with more rapid and higher levels of CTL production to the more stable complexes HLA-A2/M1 and HLA-A2/Melan-A, which score 30 and 28 on the SYFPEITHI database, compared to HLA-A2/WT1 which scores only 22 (Rammensee 1999). Preferably, peptides used in the present invention have high stability as assessed by this technique.

[0470] The specificity characteristics of the alloreactive. CTLs produced were investigated by staining with a panel of HLA-A2 tetramers. In FIG. 25, the results demonstrate that the CTLs produced from donor PS using targeted HLA-A2/MelanA and HLA-A2/WT1 complexes showed only significant staining with the appropriate tetramer, with no increase in the staining with the other tetramers (HLA-A2/M1/Telo/E7). The results of the functional T2 cell chromium release assays parallel the tetramer staining with a significant degree of peptide specificity for the cells produced from donor PS to HLA-A2/MelanA (62% vs 18-27%) and HLA-A2/WT1 (61% vs 29-41%).

[0471] Similar tetramer results were shown with the CTLs from Donor BQ using targeted HLA-A2/Melan-A, however with targeted HLA-A2/WT1 the PBMCs contain populations of CD8+ve cells that stain with all 5 tetramers examined. From Donor BQ, a potential degree of functional specificity for the cells to HLA-A2/Melan-A is apparent (28% vs 15-24%), however the cells produced with HLA-A2/WT1 showed no significant increase in lysis of any of the T2 cells compared to the background level of mock targeted cells.

[0472] Without being bound by theory, the detailed interpretation of these functional Cr release assays may be limited by the advantageously simple nature of the in vitro stimulation procedure of the present invention which uses unfractionated PBMCs.. As a result, the bulk cell culture may contain other cell types in addition to CD8+ve CTLs and from the cytokine exposure some may possibly have some non-specific lytic activity. It is also theoretically possible that the bulk population, even from Donor PS, may contain populations of alloreactive that can recognise A2 targets but may not bind specific tetramers.

[0473] This example demonstrates that the use of targeted HLA class I/peptide complexes according to the present invention is a simple and powerful method for generating alloreactive CTLs. From the three donors investigated in this example, it is also apparent that targeted HLA class I/peptide complex can produce mixed populations of alloreactive CTLs, including those that may be peptide specific, as judged by tetramer staining and functional assays, cells that may recognise HLA-A2 with any peptide, and potentially a population of non-tetramer staining cells that may recognise HLA-A2 with any peptide. These results are in keeping with the previous observations of the width of the alloreactive response to single epitope stimulation (Sadovnikova 1998, Moris et al. 2001, Dutoit 2002)

[0474] This example also demonstrates that alloreactive CTL induction with a single HLA class I/peptide complex advantageously produce either completely or predominantly peptide specific CTLs. However, from some donors there may possibly be produced a proportion of peptide non-specific cells. Without being bound by theory, it is possible that these in vitro results could be a parallel to the situations that occur in vivo in bone marrow allograft patients. Here these differing responses could represent the extremes of beneficial graft versus leukaemia as in the PS donor and broad non-specific graft versus host disease as with the BQ donor response to HLA-A2/WT1. Nevertheless, checking the quality and form of the response is easily accomplished as shown herein, so that only suitable CTLs are infused into subjects according to the present invention.

[0475] The systems of the present invention could serve as screening approaches to indicate which allograft donor recipient mismatches are likely to produce a predominant graft versus leukaemia effect with minimised graft versus host disease. Using the HLA class I/peptide targeted B cells in vivo post transplant may advantageously also lead to the selective expansion of CTLs that recognise leukaemic cells without producing GVHD.

[0476] For tumour immunotherapy with either adoptive transfer of CTLs or TCR mediated gene therapy the requirement is the production of alloreactive CTLs that are peptide specific. As this example demonstrates, the present invention provides such CTLs and methods for making them.

References

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[0498] All publications mentioned in the above specification are herein incorporated by reference. Various modifications and variations of the described methods and systems of the present invention will be apparent to those skilled in the art without departing from the scope and spirit of the present invention. Although the present invention has been described in connection with specific preferred embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention which are obvious to those skilled in immunology, biochemistry and biotechnology or related fields are intended to be within the scope of the following claims. 

We claim:
 1. A method for producing antipeptide cytotoxic T lymphocytes (CTLs) comprising: (a) attaching a complex of a class I HLA and a peptide to antigen presenting cells (APCs) present in a sample of peripheral blood lymphocytes (PBLs); (b) optionally removing excess class I HLA/peptide complex; and (c) incubating with proliferative cytokine.
 2. The method according to claim 1, wherein the APC is a B-cell.
 3. The method according to claim 1, wherein the complex is attached to the APC by attachment means comprising a molecule that selectively binds to a B cell.
 4. The method according to claim 1, wherein the attachment means comprises sfvSA to CD20 or CD19.
 5. The method according to claim 1, wherein said sample of PBLs is a sample of a class I HLA negative PBLs.
 6. The method according to claim 5, wherein the class I HLA is HLA-A2.
 7. The method according to claim 1, wherein the peptide is a tumour peptide.
 8. The method according to claim 7, wherein the tumour peptide is selected from the group consisting of Melan-A, WT1 and a telomerase.
 9. The method according to claim 1, wherein the proliferative cytokine is a combination of IL-7 and IL-2.
 10. The method according to claim 1, wherein the incubation is about 7 days.
 11. The method according to claim 10, wherein the incubation step is repeated for about 7 days further.
 12. A CTL obtainable by the method of claim
 1. 13. A method of treating a subject in need thereof, comprising administering the CTL according to claim 12 to said subject.
 14. A CTL obtained by the method of claim
 1. 15. A method of treating a subject in need thereof, comprising administering the CTL according to claim 14 to said subject. 